Endoclip-Assisted Cannulation for a Hidden Duodenal Papilla: Three Cases.

Selective cannulation during endoscopic retrograde cholangiopancreatography can be particularly challenging when the papilla is invisible, either due to an intradiverticular papilla (IDP) or because it is covered by a mucosal fold. Endoclipassisted cannulation is an effective and safe technique for everting and fixing the papilla and it can be used alone or in combination with other devices. In this report, we achieved successful papillary cannulation in two cases of IDP and one case where the papilla was covered by a mucosal fold. In two cases, cannulation was accomplished by repositioning the invisible papilla using an endoclip alone, while in one case, we used an endoclip-assisted technique to push a redundant fold with a catheter. Endoclipassisted papillary cannulation can be applied in different situations, either alone or in combination with other devices. [ABSTRACT FROM AUTHOR]