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World J Gastrointest Endosc. Mar 25, 2016; 8(6): 282-287
Published online Mar 25, 2016. doi: 10.4253/wjge.v8.i6.282
Endoscopic retrograde cholangiopancreatography in periampullary diverticulum: The challenge of cannulation
Ahmed Youssef Altonbary, Monir Hussein Bahgat
Ahmed Youssef Altonbary, Monir Hussein Bahgat, Department of Hepatology and Gastroenterology, Mansoura Specialized Medical Hospital, Mansoura 35516, Egypt
Author contributions: Altonbary AY and Bahgat MH contributed equally the conception, design and performance of this study; Altonbary AY wrote the manuscript; Bahgat MH revised the manuscript for important intellectual content.
Conflict-of-interest statement: Neither of the authors has any conflict of interest related to the publication of this study.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Ahmed Youssef Altonbary, MD, Department of Hepatology and Gastroenterology, Mansoura Specialized Medical Hospital, Dakahlia Governorate, Mansoura 35516, Egypt. a.tonbary@gmail.com
Telephone: +2-100-5100091 Fax: +2-50-2200878
Received: December 6, 2015
Peer-review started: December 7, 2015
First decision: December 22, 2015
Revised: January 5, 2016
Accepted: January 29, 2016
Article in press: January 31, 2016
Published online: March 25, 2016
Processing time: 106 Days and 20.4 Hours
Core Tip

Core tip: Presence of periampullary diverticulum (PAD) is thought to complicate the application of endoscopic retrograde cholangiopancreatography, which is already a technically difficult procedure. To improve success rates, different techniques have been developed to achieve successful biliary cannulation in patients with PAD. For patients with PAD, endoscopists must be aware of papilla identification and the different available cannulation techniques, as well as the technical feasibility and safety of each.