Publication Name	World Journal of Gastroenterology
Manuscript ID	114936
Country	India

Category	Gastroenterology & Hepatology
Manuscript Type	Minireviews
Article Title	Technical overview of difficult biliary cannulation in endoscopic retrograde cholangiopancreatography: A guide for the endoscopist
Manuscript Source	Invited Manuscript
All Author List	Shubhra Mishra, Jahnvi Dhar, Stefano F Crinò and Jayanta Samanta
Funding Agency and Grant Number
Corresponding Author	Jayanta Samanta, Additional Professor, DM, Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Sector-12, Nehru Hospital, Chandigarh 160012, India. invincible.doc@gmail.com
Key Words	Endoscopic retrograde cholangiopancreatography; Bile duct; Needle knife; Double guidewire; Rendezvous; Transpancreatic sphincterotomy; Pancreatitis
Core Tip	Difficult biliary cannulation remains a significant challenge during endoscopic retrograde cholangiopancreatography, even in expert hands and high-volume centers, which has been shown to directly impact technical success and patient outcomes. This comprehensive review highlights current strategies available in hand for managing such clinical scenarios when encountered, including early identification of risk factors, optimized guidewire techniques, and the judicious use of advanced approaches such as pre-cut sphincterotomy, double guidewire technique, transpancreatic septotomy and endoscopic ultrasound -guided rendezvous technique. Understanding the timing and escalation to alternative methods or referral is critical. A structured, stepwise approach by practising endoscopists enhances technical success and reduces complications in such challenging clinical scenarios.
Citation	Mishra S, Dhar J, Crinò SF, Samanta J. Technical overview of difficult biliary cannulation in endoscopic retrograde cholangiopancreatography: A guide for the endoscopist. World J Gastroenterol 2026; In press

Received	2025-10-09 16:31
Peer-Review Started	2025-10-09 16:31
First Decision by Editorial Office Director	2025-10-23 09:25
Return for Revision	2025-10-23 09:25
Revised	2026-02-06 07:46
Publication Fee Transferred
Second Decision by Editor	2026-03-23 02:44
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-03-23 09:00
Articles in Press	2026-03-23 09:00
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	1007-9327 (print) and 2219-2840 (online)
Open Access	This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Copyright	©Author(s) (or their employer(s)) 2026. No commercial re-use. See Permissions. Published by Baishideng Publishing Group Inc.
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