A Comparative Study of Transpancreatic Sphincterotomy, Double Guidewire Technique, and Precut Sphincterotomy in Difficult Naive Biliary Cannulations in a Tertiary Care Center in Western India

Introduction Difficult biliary cannulation leads to prolonged papillary manipulation and repeated attempts at cannulation are known to increase the risk of postendoscopic retrograde cholangiopancreatography (ERCP) pancreatitis. This study aims to compare the efficacy and complications of three rescue methods, transpancreatic biliary sphincterotomy (TP), double guidewire technique (DGW), and precut sphincterotomy (precut) in difficult common bile duct (CBD) cannulations.