The macroscopic appearance of the major duodenal papilla influences bile duct cannulation: a prospective multicenter study by the Scandinavian Association for Digestive Endoscopy study group for ERCP.

The endoscopic appearance of the major duodenal papilla influences bile duct cannulation. Small, Type 2, and protruding or pendulous Type 3 papillae are more frequently difficult to cannulate. In addition, cannulation might even fail more frequently if a beginner starts cannulation. These findings have to be taken into consideration when performing studies regarding bile duct cannulation and in training future generations of endoscopists.