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Healthcare Professionals / GastroenterologyHPB Portfolio / Practical Solutions / Access

The importance of luminal access 

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Luminal access to the biliary and pancreatic ducts remains a cornerstone to the success of ERCP procedures. Without the ability to reach the relevant target, it becomes difficult to diagnose and/or perform therapeutic maneuvers.

Thus, overcoming challenges in ductal access may contribute to improving ERCP outcomes. 

Challenges to luminal access and risk of complications remain a part of HPB endoscopy

The hepato-pancreato-biliary (HPB) system is characterized by multiple ducts, branching out in close proximity of one another.

Despite 5 decades of improved duodenoscopes and accessories, deep cannulation of the desired duct in a native papilla remains the most challenging step to successful completion of the ERCP procedure.1

How to best achieve a safe and effective bile duct cannulation during ERCP has always been, and still is, a much-debated issue. Both technical and patient-related aspects of cannulation and cannulation difficulties have previously been investigated.2

Surgically altered HPB anatomy may also introduce additional challenges to successful cannulation.3 These challenges can result in repeat procedures, delayed therapy, and increased costs.4 To overcome them, thoughtful and innovative solutions are needed.

Luminal access-related ERCP complications are well-documented5,6


Post-ERCP pancreatitis

rising to 14,7% in high-risk patients



29% of these cases are severe 






(including cholangitis and cholecystitis) 

A holistic approach to the HPB (hepato-pancreato-biliary) pathway

Explore the Boston Scientific innovations that facilitate smooth access

Short wire technology

The RX Biliary SystemTM puts the physician in control and helps to reduce complications and save on resources

Direct visualization 

Visualize bile duct with clarity to assist with guidewire placement

Lumen-apposing metal stenting 

Create a secure, translumenal conduit with the Hot AXIOSTM Stent and Electrocautery-Enhanced Delivery System

Percutaneous transhepatic cholangioscopy 

PTCS with the SpyGlass™ Discover is a minimally invasive approach for complex patients with limited treatment options

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