The Art of Selective Cannulation at ERCP

  • John T. CunninghamEmail author
Pancreas and Biliary Tract (O Haluszka, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Pancreas and Biliary Tract


Purpose of Review

ERCP is undergoing its 50th anniversary with a steady conversion from a diagnostic procedure to a therapeutic procedure. This paper shows a reflection of my 42 years of experience in the accession of biliary and pancreatic ducts and how the techniques have evolved to achieve a high rate of primary duct cannulation.

Recent Findings

There has been an increase in the primary approach to cannulation involving different cannulation catheters and guidewires, and we will review some of those available, realizing that the selection may vary depending on operator preference and team approach. Different views and experiences with these techniques will be presented.


ERCP has evolved from a diagnostic to primarily a therapeutic procedure. This has resulted in the development of a variety of devices and techniques to access the ducts of interest. I have presented several of the techniques and my team approach that has evolved over a number of years. A more prospective evaluation of devices and wires is needed to see if one is superior to the other.


Endoscopic retrograde cholangiopancreatography ERCP Billroth II Duodenal diverticulum Major ampulla Minor ampulla 


Compliance with Ethical Standards

Conflict of Interest

The author declares that there is no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.School of Medicine, Banner University Medical CenterUniversity of ArizonaTucsonUSA

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