[Are all possibilities of using standard instruments explored in difficult cannulations of the major duodenal papilla?].

An analysis of 132 patients with the most difficult cannulation of the major duodenal papilla was made. The procedure efficiency increased by 15.2% after using a Dormia basket. Different kinds of endoscopic papillotomy used with the application of standard instrument have also increased the efficiency of cannulation from 70.5 to 95.4%. Complications and lethality made 11.4 and 1.5% respectively. These results are considered to be not high under conditions of the most difficult cannulation of the major duodenal papilla. The opportunities of application of standard instruments for difficult cannulations have not been exhausted yet. Continuous search for new technical developments can considerably improve the results.