{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,1,30]],"date-time":"2025-01-30T00:50:38Z","timestamp":1738198238855,"version":"3.34.0"},"reference-count":10,"publisher":"Georg Thieme Verlag KG","issue":"CP","license":[{"start":{"date-parts":[[2025,1,2]],"date-time":"2025-01-02T00:00:00Z","timestamp":1735776000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endosc Int Open"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>There are few salvage techniques for achieving biliary cannulation when no duct can be accessed.<\/jats:p><jats:p>We retrospectively reviewed 10 consecutive cases in which the mini-forceps traction-assisted cannulation technique (MFTAC) was used after failure of any duct access during endoscopic retrograde cholangiopancreatography (ERCP). Outcomes included technical success, use of adjunct techniques; time to biliary access; and adverse events (AEs).<\/jats:p><jats:p>Most patients had a native papilla (n = 9) of peri-diverticular location (n = 5) and a benign indication (n = 6). Standard cannulation was unsuccessful over 8:23 mm:ss (interquartile range [IQR] 6:04\u201319:43). MFTAC had 100% technical success, achieved biliary access after 17:38 mm:ss (IQR 8:52\u201320:31), and had a 10% incidence of AEs (post-ERCP pancreatitis). MFTAC was sufficient to allow biliary cannulation in three cases and allowed pancreatic duct access in seven cases, which then allowed biliary cannulation with double-wire technique (5\/10) and transpancreatic septotomy (2\/10).<\/jats:p><jats:p>MFTAC is a feasible salvage approach for biliary access when standard cannulation methods fail.<\/jats:p>","DOI":"10.1055\/a-2509-7369","type":"journal-article","created":{"date-parts":[[2025,1,2]],"date-time":"2025-01-02T23:57:11Z","timestamp":1735862231000},"source":"Crossref","is-referenced-by-count":0,"special_numbering":"S","title":["Use of the mini-forceps traction-assisted cannulation technique when standard ERCP methods fail: Single-center retrospective study"],"prefix":"10.1055","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7277-4027","authenticated-orcid":false,"given":"Ankit","family":"Mishra","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Michigan, Ann Arbor, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles","family":"Meade","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Allison R.","family":"Schulman","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George","family":"Philips","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jorge D.","family":"Machicado","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,1,29]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"657","DOI":"10.1055\/s-0042-108641","article-title":"Papillary cannulation and sphincterotomy techniques at ERCP: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline","volume":"48","author":"PA Testoni","year":"2016","journal-title":"Endoscopy"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"957","DOI":"10.1016\/j.gie.2019.07.014","article-title":"Macroscopic appearance of the major duodenal papilla influences bile duct cannulation: a prospective multicenter study by the Scandinavian Association for Digestive Endoscopy Study Group for ERCP","volume":"90","author":"E Haraldsson","year":"2019","journal-title":"Gastrointest Endosc"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"1361","DOI":"10.7326\/M24-0092","article-title":"Endoscopic ultrasound-guided rendezvous technique versus precut sphincterotomy as salvage technique in patients with benign biliary disease and difficult biliary cannulation: A randomized controlled trial","volume":"177","author":"A Choudhury","year":"2024","journal-title":"Ann Intern Med"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1901","DOI":"10.1007\/s10620-021-06983-7","article-title":"Success and safety of needle knife papillotomy and fistulotomy based on papillary anatomy: A prospective controlled trial","volume":"67","author":"QS Zhang","year":"2022","journal-title":"Dig Dis Sci"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1097\/SLE.0000000000000543","article-title":"Two biliary cannulation techniques for ERCP in patients with intradiverticular papilla: A retrospective review","volume":"28","author":"L Huang","year":"2018","journal-title":"Surg Laparosc Endosc Percutan Tech"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"418","DOI":"10.1016\/j.vgie.2023.06.014","article-title":"Clip-and-line traction method for difficult ERCP cannulation due to choledochocoele","volume":"8","author":"MH Bonnichsen","year":"2023","journal-title":"VideoGIE"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"e95","DOI":"10.1111\/den.14574","article-title":"Usefulness of clip-band traction device for biliary cannulation in a case of intradiverticular papilla","volume":"35","author":"K Saito","year":"2023","journal-title":"Dig Endosc"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"E514","DOI":"10.1055\/s-0034-1377365","article-title":"SpyBite-assisted biliary cannulation for intradiverticular papilla during ERCP","volume":"46","author":"JM Levenick","year":"2014","journal-title":"Endoscopy"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"41","DOI":"10.5114\/ceh.2018.73370","article-title":"Cannulation in patients with large periampullary diverticulum using SpyBite miniforceps","volume":"4","author":"M Balkrishanan","year":"2018","journal-title":"Clin Exp Hepatol"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"6455","DOI":"10.1007\/s00464-020-08136-9","article-title":"Morphology of the major papilla predicts ERCP procedural outcomes and adverse events","volume":"35","author":"R Mohamed","year":"2021","journal-title":"Surg Endosc"}],"container-title":["Endoscopy International 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