Endoscopic retrograde cholangiopancreatography (ERCP) is the standard procedure for biliary drainage (BD) in patients with benign or malignant biliary obstruction. [1] Therapeutic ERCP requires deep cannulation into the common bile duct (CBD), the success rate of deep cannulation is high, but still not perfect, even with the use of advanced cannulation techniques such as precut sphincterotomy.[...

Two simple techniques for central venous cannulation by percutaneous puncture of the right internal jugular vein are described. They have been employed routinely for the last six months in all patients requiring central venous cannulation. No serious complications or difficulties have been encountered in a series of two hundred cases. The method allows free movement of the limbs postoperatively...

Q: there anything I can do to be more successful cannulating an upper arm fi s t u l a that rolls or retracts into the tissue upon attempted cannulation? Even stretching the skin does not help much. A: access is a hemodialysis patient’s lifeline, and successful cannulation is critical to the viability of the vascular access. One of the best ways to preserve the access is to try to make every ca...

OBJECTIVE Intravenous cannulation is a widespread medical procedure that can be difficult in children. Visualization of veins with near-infrared (NIR) light might support intravenous cannulation. Therefore, we investigated the effectiveness of an NIR vascular imaging system (VascuLuminator) in facilitating intravenous cannulation in children in the operating room. METHODS This was a pragmatic...

BACKGROUND The site of cannulation for repair of ascending aortic dissection remains controversial. We present our experience with ascending aortic cannulation for acute aortic dissection type A. METHODS AND RESULTS From January 1988 to September 2007, we operated on 242 patients for acute aortic dissection type A. Medical records of 235 patients who received ascending aortic cannulation or f...

Pediatric peripheral venipuncture and intravenous cannulation are difficult. However, successful venipuncture and intravenous cannulation are absolutely required for pediatric clinical risk management. This study assessed the success rate of venipuncture and intravenous cannulation when transmitted light was applied to the pediatric dorsum manus. The subjects included 100 young children who wer...

We compared the economics of using two-dimensional ultrasound locating devices and more traditional landmark methods for central venous cannulation in the National Health Service (NHS). The evaluation consisted of a systematic review of randomised controlled trials and an economic evaluation using decision analytic cost-effectiveness modelling. Incremental costs per complication avoided associa...

OBJECTIVE To assess the clinical efficacy of alternative techniques for biliary stricture cannulation in patients undergoing living donor liver transplantation (LDLT), after cannulation failure with a conventional (0.035-inch guidewire) technique. SUBJECTS AND METHODS Of 293 patients with biliary strictures after LDLT, 19 (6%) patients, 11 men and 8 women of mean age 48.5 years, had the faile...

BACKGROUND The VeinViewer (Luminetx, Memphis, TN) helps identify veins by projecting an image of subcutaneous vasculature on the skin surface. We tested the primary hypothesis that VeinViewer use improves cannulation success by skilled nurses in pediatric patients with anticipated difficult IV access. A secondary goal was to evaluate the relationship between obesity and cannulation success. M...

OBJECTIVE To assess the efficacy, acceptability, and safety of a topical alkane vapocoolant in reducing pain during intravenous cannulation in adults. DESIGN Randomised double blind placebo controlled trial. SETTING Emergency department of a metropolitan teaching hospital. PARTICIPANTS 201 adult patients (54% male), mean (SD) age 58.2 (19.5) years, who required intravenous cannulation. ...