Pancreatic stent during biliary cannulation: How can we catch 2 hares?

Unintentional guidewire insertion to the pancreatic duct commonly occurs during biliary cannulation and provokes post-ERCP pancreatitis (PEP).1 Several cannulation approaches have been reported in this setting.2,3 In a recent issue of Gastrointestinal Endoscopy, Eminler et al4 reported that the double-guidewire (DGW) method was superior to wire-guided cannulation after pancreatic stent placement (WGC-PS) in terms of the successful cannulation rate: 90% versus 54%. Notably, they proceeded to precut sphincterotomy over a pancreatic stent after 5 minutes of cannulation attempts.

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