Table 1.
Main differences for the endoscopist between the main steps of endoscopic procedures at the papilla of Vater for CBD exploration comparing RV with standard ERCP-ES
| Factors of difference of the endoscopic procedure | RV | ERCP-ES |
| (1) Position of the patient | Supine | Lateral |
| Rarely more difficult endoscopy | Preferred because of habit | |
| (2) Cholangiography | Antegrade transcystic | Retrograde |
| Positive (time reduction) | Negative | |
| (3) Wirsung injection (chemical damage) | Absent | Possible |
| Positive (risk reduction) | Negative | |
| (4) Ductal hyperpression (physical damage) | Absent | Frequent |
| Positive (risk reduction) | Negative | |
| (5) Guide wire help for papilla cannulation | Transcystic | Retrograde |
| Positive (time reduction) | Negative | |
| (6) Flushing of the CBD | Antegrade during basket retrieval (synergic) | Retrograde |
| Positive (time reduction) | Not synergic | |
| (7) Papilla manipulation causing oedema or Oddi’s spasm | Limited or absent | Frequent |
| Positive (risk reduction) | Negative | |
| (8) Precut of the Papilla | Absent | Possible |
| Positive (risk reduction) | Negative | |
| (9) Reduction of the steps of endoscopic procedure | Possible | Uncommon |
| Positive (time reduction) | Negative | |
| Total of positive factors | 8/9 | 1/9 |