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Advanced Digestive Endoscopy - ERCP by Peter B. Cotton

By Peter B. Cotton

The most recent variation of the world-leading identify useful Gastrointestinal Endoscopy (published in may possibly 2003) has a 'back to fundamentals' process - putting emphasis on perfecting the fundamental concepts of endoscopy. there's now a necessity for particular functional and scientific publications to the complicated endoscopy suggestions for more matured physicians.

Advanced Digestive Endoscopy: ERCP addresses the most advanced diagnostic and healing systems for endoscopists. It offers the newest considering and transparent guide at the innovations, which were built-in with total sufferer care.

Written through the best overseas names in endoscopy, the textual content has been expertly edited by means of Peter Cotton right into a succinct, instructive layout. offered in brief paragraphs based with headings, subheadings and bullet issues and richly illustrated all through with full-color images.

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Sample text

It can be identified as a small protruding structure. It may not be obvious or may appear as a slightly pinkish nipple between the duodenal folds. When prominent, it can sometimes be mistaken for the main papilla; however, it does not have a distinct longitudinal fold and the small opening usually resists cannulation. Cannulation of the minor papilla is indicated in patients with suspected or proven pancreas divisum and when cannulation of the pancreatic duct fails at the main papilla. Cannulation of the minor papilla is usually best performed in a long scope position using a 3 mm fine metal tip cannula.

A portable digital C-arm unit can be used but the resolution may be inferior to the full digital unit. It is preferable to use a machine with an under-couch X-ray tube. The X-ray machine should be capable of taking spot films. Digital units can store the images onto a computer for subsequent retrieval and review. Hard copies of selected images can be printed for reporting and filing. It is essential to know the magnification Fig. 6 Fluoroscopy machine with under-couch tube. Digital C-arm for designated ERCP room.

Minor papilla cannulation The minor papilla is located proximally and to the right of the main papilla. It can be identified as a small protruding structure. It may not be obvious or may appear as a slightly pinkish nipple between the duodenal folds. When prominent, it can sometimes be mistaken for the main papilla; however, it does not have a distinct longitudinal fold and the small opening usually resists cannulation. Cannulation of the minor papilla is indicated in patients with suspected or proven pancreas divisum and when cannulation of the pancreatic duct fails at the main papilla.

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