Endoscopic view of metallic stent at common bile duct orifice.
Sometimes bile duct cannulation requires orientation of the cannula in a cephalad direction. This can be accomplished by using a sphincterotome. Tightening the cutting wire bows the cannula upward and produces a more cephalad orientation for the tip of th
Lifting the cannula to insert it along the “roof ” of the papilla increases the likelihood of entry into the bile duct.