Endoscopic treatment for pancreatic diseases: Needle-knife-guided cannulation via the minor papilla

Figure 4 “Needle-knife introduction of a guidewire” procedure. A: The cannula of the needle-knife approaching the minor papilla orifice; B: The needle tip was extended 3 to 5 mm beyond the cannula tip and aimed at the orifice; C, D: The needle tip was inserted into the orifice; E: The cannula of the needle-knife was placed on the minor papilla orifice and a guidewire was advanced through the cannula; F: The cannula was inserted into the capitular head of the duct of Santorini along the guidewire and advanced continually; G: Contrast material was injected and the location within the duct of Santorini was confirmed; H: The needle-knife was removed; I: The guidewire was left in place.