ERCP Goff Precut胰腺支架

                               
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When cannulation of the common bile duct is difficult, a precut sphincterotomy can be considered. If the pancreatic duct has been cannulated, a transpancreatic precut (Goff precut) can be performed. With the sphincterotome in the pancreatic duct, the cutting wire is aimed towards the 11 o'clock direction. After the precut, the bile duct can be cannulated freehand, or the wire can be left in the pancreatic duct to maintain the ampulla in a good position. Another option is to place a pancreatic stent after the precut, as in this case. The pancreatic stent can help orient the anatomy and the likely direction of the bile duct may become more obvious.