Abstract
The main duodenal papilla is found inside a diverticulum in 5% to 23% of patients in ERCP series. Identification of the orifice and selective cannulation of each duct can be a complex problem, particularly when the papilla is on the edge of the diverticulum and facing inside it. Technical modifications of the ERCP procedure are required to increase its success. The present report describes the simultaneous use of two endoscopes to gain access to the bile duct.
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