Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Gastrointest Endosc. Jun 16, 2026; 18(6): 118152
Published online Jun 16, 2026. doi: 10.4253/wjge.v18.i6.118152
Published online Jun 16, 2026. doi: 10.4253/wjge.v18.i6.118152
Biliary cannulation techniques: Optimizing success and minimizing risk
Aryan Jain, Mayur Pabba, Department of Gastroenterology, Albany Medical College, Albany, NY 12208, United States
Aditya Jain, Department of Gastroenterology, Nova Southeastern University, Fort Lauderdale, FL 33328, United States
Savita Madhankumar, Department of Gastroenterology and Hepatology, Albany Medical Center, Albany, NY 12208, United States
Sahib Singh, Department of Gastroenterology, SUNY Upstate University, Syracuse, NY 21215, United States
Saurabh Chandan, Department of Advanced Endoscopy, Houston Methodist West Hospital, Houston, TX 77094, United States
Muhammad Khalid Hasan, Mustafa A Arain, Center for Interventional Endoscopy, AdventHealth, Orlando, FL 32804, United States
Co-corresponding authors: Saurabh Chandan and Mustafa A Arain.
Author contributions: Singh S, Chandan S, Hasan MK, and Arain MA designed the research study; Jain A (the first author), Pabba M, Madhankumar S, and Jain A (the third author) performed the research and wrote the manuscript; Singh S, Chandan S, Hasan MK, and Arain MA reviewed the final draft; Chandan S and Arain MA made equal contributions as co-corresponding authors. All authors approved the final version to publish.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Mustafa A Arain, Professor, Center for Interventional Endoscopy, AdventHealth, 601 E Rollins Street, Orlando, FL 32804, United States.
Received: December 25, 2025
Revised: April 7, 2026
Accepted: May 7, 2026
Published online: June 16, 2026
Processing time: 167 Days and 14.4 Hours
Revised: April 7, 2026
Accepted: May 7, 2026
Published online: June 16, 2026
Processing time: 167 Days and 14.4 Hours
Core Tip
Core Tip: Biliary cannulation remains a technically demanding but essential component of endoscopic retrograde cholangiopancreatography, with success depending not only on operator expertise but also on careful selection and timely escalation of techniques. Knowledge of the risks and benefits of approaches ranging from wire-guided cannulation to precut and pancreatic duct-assisted methods is critical for minimizing complications such as post-endoscopic retrograde cholangiopancreatography pancreatitis, bleeding, and perforation.