How I cannulate the bile duct

Next year will mark the 50th anniversary of the first report of ERCP. 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 procedure. Although many reports attempt to distill cannulation down to a science, it remains primarily an art. No single technique is uniformly successful. We hope that providing our thoughts on basic principles of cannulation will improve your cannulation success rate.

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