Please select the eligibility criteria that correspond to the clinical trial below.
Title: N/A
Brief Summary: Selective cannulation of common bile duct (CBD) by insertion of a guide-wire seems to be associated with fewer complications and post-ERCP (Endoscopic retrograde cholangiopancreatography) pancreatitis (PEP) rate than the conventional biliary tree access with cannulotome (CT-25 Cook Medical) with contrast injection even if results are conflicting. the aim of our study is to test a new guide-wire (loop-tip wire), with a loop in the tip, for the prevention of PEP and biliary tree access, in PEP high-risk patients.


Options:
A: Inclusion Criteria:

* All patients referred for ERCP who have an intact naïve papilla are considered for inclusion

Exclusion Criteria:

* Age \<18yrs
* Acute illness (hypotension: BP\<90mmHg, hypoxia: O2 \<95%, haemodynamic instability)
* Inability or refusal to give informed consent.
* Patients with previous sphincterotomy
* Pancreatic or ampullary cancer are excluded as post-ERCP pancreatitis (PEP) is very uncommon in these subgroups and tumour-related anatomical variation may alter cannulation technique.

(consider substratify results for this subgroup, but exclude if duodenal stenosis precludes an attempt on the papilla)

* Patients with surgically altered anatomy (Bilroth II gastrectomy and Roux en Y anastomosis) are excluded as cannulation technique is fundamentally different from that in normal anatomy.
B: Inclusion Criteria:

* Age over 18 years
* Clinical and/or radiological suspicion of Bile Duct Diseases which require ERCP procedure with intention of selective biliary cannulation
* Patients must be admitted in the participant hospitals of the investigators units
* Written informed consent of the patient, relative or legal tutor

Exclusion Criteria:

* Previous biliary or pancreatic sphincterotomy
* Previous pneumatic dilatation of duodenal papilla
* Presence of biliary-digestive derivation
* Previous diagnosis or suspected pancreas divisum
* Use of any biliary or pancreatic stent in the last 6 months
* Use of any drug aimed to reduce post-ERCP pancreatitis
* Pregnancy or maternal feeding
* Previous inclusion in the study
C: Inclusion Criteria:

1 Subjects who are undergoing endoscopic retrograde cholangiopancreatography (ERCP)

* Age \> 18 years
* Non-pregnant
* Non-prisoners
* Subjects who can sign informed consent
* Serum Creatinine \< 1.2 milligrams/deciliter (mg/dL)
* Subjects without renal failure (acute or chronic)
* Subjects without congestive heart failure (ejection fraction \< 40%)
* Subjects without cirrhosis of the liver
* Subjects without allergy to aspirin or non-steroidal anti-inflammatory drugs (NSAIDS)
* Subjects not on non-steroidal anti-inflammatory drugs NSAIDS prior to enrollment

Exclusion Criteria:

* Subjects who are not undergoing ERCP
* Age \< 18 years
* Pregnancy
* Prisoners
* Subjects lacking the capacity to consent for themselves
* Serum Creatinine \> 1.2 milligrams/deciliter (mg/dL)
* Subjects with renal failure (acute and chronic)
* Subjects with congestive heart failure (ejection fraction \< 40%)
* Subjects with cirrhosis of the liver
* Subjects with allergy to aspirin or non-steroidal anti-inflammatory drugs (NSAIDS)
* Subjects with gastrointestinal hemorrhage
* Subjects on chronic non-steroidal anti-inflammatory drugs NSAIDS
* Subjects with acute pancreatitis the day of their procedure (CITE 1-3)(APPENDIX 1)
D: Inclusion Criteria:

* high-risk patients for post-ERCP pancreatitis

Exclusion Criteria:

* age \< 18 years
* allargy to the contrast medium
* previous biliary or gastric surgery
* neoplastic patients
* previous biliary or pancreatic sphincterotomy

Answer: D