Endoscopic transpancreatic septotomy as a precutting technique for difficult bile duct cannulation

Figure 1 Septum between the pancreatic duct and common bile duct.

Figure 2 Transpancreatic septotomy procedure. A guidewire enters the pancreatic duct (A); the septum is cut from the pancreatic duct to the bile duct (B); the catheter is inserted toward the bile duct (C); and the guidewire enters the bile duct (D).