Bile Duct Access Tunnel to Reduce Post-ERCP Pancreatitis

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Solution Overview

Problem

Endoscopic retrograde cholangiopancreatography (ERCP) procedures often result in severe post-ERCP pancreatitis due to impaired pancreatic fluid outflow caused by stimulation of the duodenal papilla and pancreatic duct openings during bile duct access.

Innovation Solution

A method is developed to form a tunnel from the oral ridge of the duodenal papilla to the bile duct without touching the pancreatic duct opening, using a needle to pierce and create a pathway, and then dilate the tunnel using a stent or other devices to facilitate access.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Reliability

If a natural opening of the duodenal papilla or pancreatic duct ostium is stimulated during conventional ERCP to access the bile duct, then bile duct access is achieved, but post-ERCP pancreatitis occurs due to impaired pancreatic fluid outflow

Engineering Contradiction:

Improvebile duct access successVSAvoidpost-ERCP pancreatitis

Core Design Contradiction:

ReliabilityVSObject-affected harmful factors

Solution Approach 1:

The patent introduces a tunnel as an intermediary pathway formed through the duodenal wall from the oral side of the duodenal papilla to the bile duct. This tunnel serves as a mediator that allows access to the bile duct without directly stimulating or touching the pancreatic duct ostium or duodenal papilla opening, thereby preventing post-ERCP pancreatitis while maintaining successful bile duct access

Inventive Principle:

Principle #24Intermediary (Mediator)

Solution Approach 2:

The access route is segmented into two distinct parts: the tunnel portion through the duodenal wall and the bile duct portion. By separating the access pathway from the pancreatic duct opening, the patent eliminates the harmful stimulation while preserving the therapeutic access to the bile duct

Inventive Principle:

Principle #1Segmentation

2Object-affected harmful factors

If a tunnel is formed from the oral ridge of the duodenal papilla to the bile duct without touching the pancreatic duct opening, then post-ERCP pancreatitis is suppressed, but the tunnel lumen requires dilation to facilitate device passage

Engineering Contradiction:

Improvepost-ERCP pancreatitis suppressionVSAvoiddevice passage through tunnel

Core Design Contradiction:

Object-affected harmful factorsVSEase of operation

Solution Approach 1:

The patent applies preliminary action by dilating the tunnel lumen before introducing therapeutic devices. The dilation step prepares the tunnel pathway in advance, creating sufficient space for smooth passage of stents, catheters, or other intervention devices while maintaining the protective effect of avoiding pancreatic duct stimulation

Inventive Principle:

Principle #10Preliminary action

Applied Scientific Principles

This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.

Function Achieved in This Case

This approach significantly reduces the risk of post-ERCP pancreatitis by avoiding stimulation of the pancreatic duct, allowing safe and effective access to the bile duct for various treatments with reduced complications.

Implementation Method 1

the tunnel is formed by piercing a needle, which is configured to energize a tissue, from the oral ridge toward the bile duct

Methodology Applied

Scientific EffectElectrocautery: Joule Heating

Data Source

PatentUS12390623B2Method for forming access route to bile duct

Publication Date: 2025.08.19 OLYMPUS MEDICAL SYST CORP

AI summary

A method of forming an access route to the bile duct includes: forming a tunnel extending from an oral ridge of a duodenal papilla, which is located on an oral side of a natural opening of a duodenal papilla, to the bile duct; and dilating a lumen of the tunnel more than when it was formed.