This research project will compare the use of the double wire technique with the placement of a pancreatic duct (PD) stent to achieve deep biliary cannulation without the use of a precut papillotomy. Currently, the data supporting either of these approaches is limited to the referenced case series. More data on the success and complication rates of these techniques are needed. The investigators believe either of these approaches would be preferred by less experienced endoscopists to precut papillotomy. Consequently, it is important to differentiate these techniques and identify which patients may benefit from one or both.

Inclusion Criteria:

• First time ERCP

Exclusion Criteria:

• Successful bile duct cannulation within six minutes
• Planned pancreatic duct therapy
• Planned pancreatobiliary manometry
• Prior successful ERCP