Table 1: Endoscopes and accessories for ERCP in biliary diseases in use in our Center.

Endoscopes

Characteristics

Pediatric diagnostic duodenoscope

 

Insertion tube 7.5 mm; distal end 7.5 mm; operative channel 2 mm

Useful for neonates and infants weighing less than 10 Kg

Narrow operative channel allows only special accessories less than 5 Fr in diameter and may results in ineffective suction when the cannula is in place

A well-experienced and trained endoscopist needs to control the tip of the sphincterotome

Metallic tip limits the use for diagnostic purpose

Diagnostic duodenoscope

Insertion tube 11 mm; distal end 12.6 mm; operative channel 3.2 mm

Useful for children by the age of 8 months and adults

Therapeutic duodenoscope

Insertion tube 11.3-12.5 mm; distal end 13.2-13.5 mm; operative channel 4.2 mm

Useful for children by the age of 7 years and adults

Accessories

Characteristics

Cannulae

Working length: 170-195 cm

Distal tip: 2.5-3.5-4-4.5-5-5.5-6 fr

Those with tapered tip allow easier cannulation of narrow papillae

Sphincterotomes, cannulotome

Lumen: double, triple

Working length: 170-195 cm

Distal tip: 4-4.5-5 fr

Different cable bending

Guide wires

Tip shape: straight or angled

Working length: 270-400 cm

Outer diameter: 0.025-0.032-0.035 in

Nasobiliary drainages

Applicable to: right hepatic duct, left hepatic duct, common bile duct

Different shapes

Insertion portion diameter: 5-6-7 fr

Biliary stents

Shape: straight, proximal bend, center bend, pigtail,

Length: 3-4-5-6-7-8-9-10-11-12-13-14-15 cm

Size: 7-8.5-10 fr

Hydrostatic dilators

Balloon diameter: 12-13.5-15-16.5-18-19-20 mm

Stone extraction balloon

Injection part: above, below

Balloon diameter: 8.5-11.5-15-18-20 mm

Stone retrieval baskets

Different shapes

Opening width: 20-22 mm

Cytology brushers

Outer diameter: 1-1.2-2-2.4-3-5 mm

Biopsy forceps

Shapes: oval, alligator, with or without needle

Different working lengths and opening sizes