Atlas of Gastroenterological Endoscopy
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EPT - guide wire directed
Guide wire in papilla Papillotoma - direction
An EPT is performed guide wire directed regularly at our institution. This ensures correct position of the papillotoma in the bile duct. The teflon covered terumo- guide wire is inserted by means of "seldinger" manoeuvre through a catheter into the bile duct (left figure). After the catheter is removed, the papillotoma is inserted over the guide wire. The location of the guide wire is continuously controlled by radiological imaging. The position of the papillotoma´s cutting device (right figure) is recommended to be vertical to the papilla´s roof (between 11:00 and 01.00 o´clock). The position shown here corresponds to 1:00 o´clock. The guide wire can be left in the bile duct during the procedure since it is teflon covered.