Modified double-guidewire technique using a unique double-lumen sphincterotome for difficult biliary cannulation.

Abstract

ERCP is widely accepted as the standard therapeutic procedure for different pancreatobiliary disorders. Selective biliary cannulation remains difficult in 5% to 10% of cases, even in the hands of experienced operators.1 Although several techniques have been proposed as alternatives for persistent conventional biliary cannulation in difficult cases such as precut sphincterotomy and needle-knife precut, the double-guidewire technique (DGT) is still considered a promising salvage approach in such cases.