How should we evaluate the biliary tract with ERCP?

Abstract

ERCP and associated procedures are widely used for the management of biliary disorders. Deep biliary cannulation is a prerequisite for successful ERCP. Achieving deep biliary cannulation can be challenging. We should not repeat the same approach and try to use alternative techniques which are tailored to the individual papillary and ductal anatomy of each patient. It is necessary to be aware of the fundamental knowledge and techniques of these procedures in order to avoid unexpected results. The indication of diagnostic ERCP should be considered carefully because there is a potential risk of post ERCP pancreatitis.