Fig. 2

Different biliary cannulation direction of a SIT patient under prone position(the same patient in Fig. 1). Endoscopic view showed that the papilla was in the right side with a longitudinal axis of 2 o’clock (A). Initial cannulation direction aiming to 11 o’clock (B) resulted in inadvertent pancreatic duct cannulation (C). Fluoroscopy showed guidewire was in the pancreatic duct. The biliary orifice (black arrowhead) at 3 o’clock was then exposed after transpancreatic precut, while the pancreatic orifice (asterisk) was at 11 o’clock (D, E). Successful biliary cannulation finally achieved (F) (white arrowhead indicating guidewire was inside of common bile duct)