The septum separating the orifices to the pancreatic and bile ducts can be oriented in any direction from horizontal to vertical. When the papilla is viewed en face, the course of the bile duct is usually toward the 10 o’clock position and the pancreatic
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.
Distal pancreatectomy with splenectomy. The figure demonstrates the proper angle of approach when transecting the pancreatic body with the 30-mm GIA stapler. The posterior aspect of the pancreas must be dissected completely to allow free passage of the st