Biliary Cannulation and Pancreatic Guide-Wire Placement

I read with interest the article by Maeda et al. on selective biliary cannulation using pancreatic guide-wire placement [1] and the accompanying editorial by Devière [2] in a recent issue of Endoscopy. I strongly support Dr. Devière’s view that we should be reluctant to accept the idea of intentionally cannulating and injecting the pancreatic duct as a method of gaining access to a difficult bile duct.