THE DIFFICULT CANNULATION MAJOR DUODENAL PAPILLA. THE REASONS AND OPPORTUNITIES

We performed a prospective analysis of endoscopic through the papillary interventions in our hospital from January 2008 to December 2012. The total number of patients was 1513 patients. Difficult cannulation cases marked by us in 607 patients (40,1 %). Men - 249 (41 %), women - 358 (59 %). The total number of completed through the papillary interventions in this group was 1887. We used almost the whole range of both diagnostic and therapeutic endoscopic through the papillary interventions used in biliary hypertension: endoscopic retrograde cholangiopancreatography (ERCP), endoscopic papillotomy (EPT), endoscopic mechanical lithotripsy and litho extraction (EMLE, EMLT) , nasobiliary drainage (NBD), biliary tract boogieing, biliary stenting, electrohydraulic lithotripsy (shock wave lithotripsy), biliary balloon dilatation. Our interventions were effective in 538 patients, which was 88,6 %. Ineffective our interventions were in 69 patients (11,4 %). Complications occurred in 33 patients (5,4 %).