Publication Name	World Journal of Gastroenterology
Manuscript ID	124407
DOI	10.3748/wjg.124407
Country	Taiwan

Category	Gastroenterology & Hepatology
Manuscript Type	Retrospective Study
Article Title	Stage-specific effects of papilla morphology and periampullary diverticulum on initial and final cannulation outcomes in endoscopic retrograde cholangiopancreatography
Manuscript Source	Unsolicited Manuscript
All Author List	Wei-Chih Su, Hung-Da Chen, Chia-Chi Wang, Tsung-Hsien Hsiao, Tzu-Hsiang Kung, Chih-Hsiang Chen and Jiann-Hwa Chen
Funding Agency and Grant Number
Corresponding Author	Jiann-Hwa Chen, Chief, MD, Division of Gastroenterology, Buddhist Tzu Chi Medical Foundation, Taipei Tzu-Chi Hospital, No. 289 Jianguo Road, Xindian District, New Taipei 23142, Taiwan. lance777@tzuchi.com.tw
Key Words	Endoscopic retrograde cholangiopancreatography; Papilla morphology; Periampullary diverticulum; Difficult cannulation; Cannulation success; Cannulation time
Core Tip	Papilla morphology and periampullary diverticulum are common anatomical variations encountered during endoscopic retrograde cholangiopancreatography (ERCP). In this retrospective study of 1257 ERCP procedures, type 4 papilla was associated with difficult cannulation and prolonged cannulation time, whereas Boix type II periampullary diverticulum was associated with more favorable cannulation outcomes. Anatomical factors primarily influenced the early phase of biliary cannulation, while their impact on final cannulation success was attenuated after the application of advanced cannulation techniques. These findings may help endoscopists anticipate cannulation difficulty and select appropriate rescue strategies before ERCP.
Citation	Su WC, Chen HD, Wang CC, Hsiao TH, Kung TH, Chen CH, Chen JH. Stage-specific effects of papilla morphology and periampullary diverticulum on initial and final cannulation outcomes in endoscopic retrograde cholangiopancreatography. World J Gastroenterol 2026; In press DOI: https://doi.org/10.3748/wjg.124407
PDF	124407-in-press.pdf

Received	2026-06-18 03:26
Peer-Review Started	2026-06-18 03:26
First Decision by Editorial Office Director
Return for Revision	2026-07-22 08:33
Revised	2026-08-05 05:57
Publication Fee Transferred	2026-08-23 15:34
Second Decision by Editor	2026-09-23 02:47
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-09-23 09:11
Articles in Press	2026-09-23 09:11
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	1007-9327 (print) and 2219-2840 (online)
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Copyright	©Author(s) (or their employer(s)) 2026. No commercial re-use. See Permissions. Published by Baishideng Publishing Group Inc.
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