Abstract
Recently, ERCP and associated procedures are widely used for the management of pancreatobiliary disorders, because of the increasing needs for minimal invasive procedures. Deep cannulation of the desired duct is a prerequisite for successful therapy at ERCP. Achieving deep biliary cannulation can be challenging at times for experts and novices alike. Endoscopists should not repeat the same approach. They should try to use alternative techniques which are tailored to the individual papillary and ductal anatomy of each patient. Endoscopic sphincterotomy (EST) is not only the first line of treatment for bile duct stones but also the first step for many therapeutic or diagnostic procedures. ERCP and associated procedures are much less invasive and involve much less manpower, preparation, and procedure time. However, procedure-related complications occur occationary. It is necessary to be aware of the fundamental knowledge and techniques of these procedures in order to avoid unexpected results.
