Digestive Diseases and Sciences

, Volume 60, Issue 1, pp 168–173 | Cite as

Endoclips to Facilitate Cannulation and Sphincterotomy During ERCP in a Patient with an Ampulla Within a Large Duodenal Diverticulum: Case Report and Literature Review

  • Mitchell S. CappellEmail author
  • Estela Mogrovejo
  • Palaniappan Manickam
  • Mihaela Batke
Case Report

Cannulation and sphincterotomy of the ampulla may be technically challenging at endoscopic retrograde cholangiopancreatography (ERCP) when the ampulla is located within a duodenal diverticulum because of obscuring of the ampulla and approaching it from an awkward angle. Successful application of endoclips to expose and facilitate cannulation of an ampulla within a duodenal diverticulum has been reported for three cases of diagnostic ERCP [1, 2] and one case of therapeutic ERCP [3]. A second case is hereby reported of clinically beneficial, successful, therapeutic ERCP using endoclips.


Cases of facilitated cannulation at ERCP in association with duodenal diverticulum were identified by computerized literature search using terms “diverticulum” and (“ERCP” or “sphincterotomy” or “papillotomy” or “stone extraction,” or “common bile duct stones” or “CBD stones” or “choledocholithiasis”). Cases of facilitated cannulation at ERCP using endoclips were identified by adding “hemoclips”...


Endoclips Hemoclips ERCP (endoscopic retrograde cholangiopancreatography) Therapeutic ERCP Sphincterotomy Duodenal diverticulum Choledochal cannulation Ampulla of Vater Choledocholithiasis 


Conflict of interest

None. This paper does not discuss any confidential pharmaceutical industry data reviewed by Dr. Cappell as a consultant for the Food & Drug Administration (FDA) Advisory Committee on Gastrointestinal Drugs.


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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Mitchell S. Cappell
    • 1
    • 2
    Email author
  • Estela Mogrovejo
    • 1
  • Palaniappan Manickam
    • 1
  • Mihaela Batke
    • 1
  1. 1.Division of Gastroenterology and Hepatology, MOB 602, Department of MedicineWilliam Beaumont HospitalRoyal OakUSA
  2. 2.William Beaumont School of MedicineOakland UniversityRoyal OakUSA

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