Pancreatic duct guidewire placement for biliary cannulation in a single-session therapeutic ERCP

Figure 1 Endoscopic view of the papilla with a hydrophilic wire advanced into the pancreatic duct. A sphincterotome is advanced alongside the pancreatic wire with its tip oriented in the anticipated bile duct position.

Figure 2 Biliary cannulation with the use of double-guidewire technique. One guidewire has been inserted into the distal part of the pancreatic duct and another is being moved in the direction of common bile duct through the sphincterotome inserted into the ampulla.