Abstract
ERCP is at the very core of my work as a therapeutic endoscopist. To kick off our series on Top Tips for performing advanced endoscopy, I thought it would be proper to start with one of the foundational fundamentals: cannulating the bile duct in a patient who has not undergone prior biliary sphincterotomy. I have said before in these pages that cannulation is the beating heart of ERCP, and I meant it. Even in 2021, many physicians still struggle with cannulation. I have been performing ERCP at a high level on a daily basis for 2 decades, and here are some of the most important things I have learned:
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