title: [Suprapapilar puncture for biliary access to advanced cancer of the papilla and severe coagulopathy].
abstract: Biliary cannulation to perform endoscopic retrograde cholangiopancreatography (ERCP) may be difficult in patients with advanced papillary cancer, due to anatomical and technical reasons. Sphincterotomy may be contraindicated in severe coagulopathy. We report a recently described technique of suprapapillary puncture for biliary access with use of an Artifon's catheter for biliary access in a high-risk patient with coagulopathy and periampullary neoplasm.
authors: Serviço de Endoscopia Digestiva, Hospital das Clinicas, Faculdade de Medicina Universidade de São Paulo, São Paulo, Brazil. eartifon@hotmail.com
authors: E
authors: E
authors: Artifon
authors: D S
authors: DS
authors: Couto
authors: A
authors: A
authors: Navarro
mesh_terms: D000368:Aged; D014670:Ampulla of Vater; D001778:Blood Coagulation Disorders / Q000150:complications*; D003138:Common Bile Duct Neoplasms / Q000150:complications* / Q000601:surgery*; D006801:Humans; D008297:Male; D011677:Punctures; D012720:Severity of Illness Index