A new cannula with a flexible tip (Swing Tip) may improve the success rate of endoscopic retrograde cholangiopancreatography

Background and Study Aims: Endoscopic retrograde cholangiopancreatography (ERCP) is sometimes unsuccessful because the anatomy of the papilla of Vater precludes cannulation by routine means. The efficacy of a new flexible tip cannula (the Swing Tip) was studied in patients in whom routine ERCP was unsuccessful. Patients and Methods: The Swing Tip cholangiographic catheter has an articulation at its tip which allows the tip to be flexed from 90degrees to 30degrees. Routine cholangiography was successful in 175 of 195 patients in whom it was attempted between September 2000 and November 2001. ERCP with the Swing Tip catheter was attempted in the 20 patients in whom ERCP had failed. Results: In 17 of 20 patients, we attempted to insert the Swing Tip catheter into the common bile duct to perform cholangiography. Insertion was successful in 11 patients and unsuccessful in six. There were no complications related to the procedure. Conclusion: The Swing Tip catheter is a useful adjunct to standard ERCP catheters for patient in whom standard techniques are unsuccessful.