Unique double guidewire technique using a guidewire perforating the diverticulum for a difficult biliary cannulation.

Abstract

Biliary cannulation of an intradiverticular papilla, classified type 1 as per the Li-Tanaka classification, is sometimes challenging [1]. Although in cases with difficult biliary cannulation the pancreatic duct guidewire placement technique is useful [2] [3], placing the guidewire in the pancreatic duct is sometimes difficult. We report a successful case of biliary cannulation in a patient with an intradiverticular papilla using an unusual double guidewire technique taking advantage of a guidewire perforating the diverticulum.