Fig. 4
From: Enlarged fistulotomy of the papilla as access to the biliary tract during ERCP
Enlarged fistulotomy of the papilla. a failed cannulation with the sphincterotome and guide wire; b failed cannulation with the guide wire and after injection of a small amount of contrast; c EFP with wide incisions; d dissection of the papilla; e identification of the muscular sphincter of the papilla, the muscular fibers, and the common bile duct mucosa; f easy cannulation of the bile duct after dissection; g dilation with 12 mm balloon of the fistula orifice; h common bile duct stone removal