Strategies for achieving successful cannulation in endoscopic retrograde cholangiopancreatography: A technical overview

Figure 1  The anatomy of the biliary tract.

Figure 2  Biliary and pancreatic duct routes in major papilla and classic biliary sphincterotomy.

Figure 3 Anatomical variations of major duodenal papilla. A: Regular; B: Small; C: Protruding; D: Ridged.

Figure 4 Periampullary diverticula. A: Type I; B: Type IIa; C: Type III.

Figure 5 Advanced techniques for biliary cannulation. A: Double guide-wire; B: Biliary cannulation over pancreatic stenting; C: Precut sphincterotomy over a pancreatic duct stent; D: Precut papillotomy; E: Pull type precut; F: Transpancreatic precut sphincterotomy; G: Precut suprapapillary fistulotomy.

Figure 6  Precut fistulotomy.

Figure 7 Stapfer classification. ERCP: Endoscopic retrograde cholangiopancreatography.