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
The proper cannulation angle for the pancreatic duct is nearly at right angles to the duodenal wall, while bile cannulation requires a more cephalad orientation.
The stomach is retracted cephalad as the transverse colon is retracted caudad while the omentum is divided with the harmonic scalpel.