title: Endoscopic retrograde cholangiography (ERC) through artificial endoscopic choledocho-duodenal fistula.
abstract: A new endoscopic method for retrograde cholangiography in cases of unsuccessful cannulation of the papilla is described. In 1 patient with obstructive jaundice, severe diabetes and a previous history of biliary pain traditional ERC failed. An endoscopic artificial choledocho-duodenal fistula by means of a diathermic cutter (needle type) was performed at the lower end of the intramural portion of the common bile duct for retrograde cholangiography. X-ray showed an obstruction of the common bile duct due to a carcinoma of the head of the pancreas. Complications did not occur during the procedure and in the post-operative period. It is concluded that the described method may be helpful when traditional selective ERC fails, moreover it may permit an endoscopic choledocho-duodenostomy for choledocholithiasis in cases of unsuccessful endoscopic papillo-sphincterotomy.
mesh_terms: D000368:Aged; D002758:Cholangiography / Q000379:methods*; D002779:Cholestasis / Q000175:diagnosis / Q000209:etiology; D003135:Common Bile Duct / Q000601:surgery; D004386:Duodenum / Q000601:surgery; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005402:Fistula; D006801:Humans; D010190:Pancreatic Neoplasms / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging