Cannulation of the major and minor papilla via endoscopic retrograde cholangiopancreatography: Techniques and outcomes

The success of any Endoscopic retrograde cholangiopancreatography (ERCP) is dependent on achieving successful cannulation of the desired duct via the desired route. Proper cannulation technique is critical for achieving procedure success and minimizing complications. The goal of this review is to discuss endoscopic techniques devices to help achieve successful cannulation, to detail multiple methods to assist with difficult cannulation, and to describe special circumstances that may be encountered. The manuscript will place an emphasis on cannulation techniques, while focusing on minimizing overall complications and a reduction in the incidence and severity of post-ERCP pancreatitis.