What is the appropriate patient positioning for ERCP?

For Endoscopic Retrograde Cholangiopancreatography (ERCP), the appropriate patient positioning is prone with the head turned toward the right shoulder. This positioning allows for optimal access to the duodenum, where the ampulla of Vater is located—this is the opening through which the cystic duct, common bile duct, and pancreatic duct enter the intestine.

By placing the patient in the prone position, endoscopists can achieve better visualization and access for cannulation of the bile duct, which is crucial for the success of the procedure. The right shoulder orientation helps to align the duodenum and the ampulla in such a way that facilitates easier manipulation and intervention with the endoscope.

This position also provides a comfortable and stable setting for the patient during the procedure, which can be prolonged. Proper positioning is vital for minimizing complications and ensuring that the endoscopist can efficiently complete the ERCP.