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内镜逆行胰胆管造影术（ ERCP）是一项重要的治疗性内镜技术，而胆管插管困难和 ERCP后胰腺炎仍是这一技术的难点。长时间的反复插管尝试会增加 ERCP后胰腺炎的风险。因此，掌握各种新型插管技术在提高插管成功率和规避 ERCP 后胰腺炎中起到极其重要的作用。该文主要阐述和分析在最初常规方法插管尝试失败后，能够提高胆管插管成功率和降低 ERCP后胰腺炎发生率的技术，包括导丝引导插管技术、括约肌切开刀辅助导丝插管技术、胰管导丝留置法（双导丝法）、胰管支架术、针状刀预切开术（包括经针状刀造瘘口插管）、经胰管括约肌预切开术等。“,”Abastrct:Endoscopic retrograde cholangiopancreatography( ERCP) is one ofthe most technically chal-lenging procedures in therapeutic endoscopy;difficulties in biliary cannulation and post-ERCP pancreatitis are still significant problems.Repeated and prolonged attempts at cannulation increase the risk of post-proce-dure pancreatitis.Therefore,cannulation technique plays a pivotal role in successful cannulation and preven-tion of post-procedure pancreatitis.Here presents and discusses the techniques that can be used for achieving biliary cannulation after an initial failure and for minimizing the risk of pancreatitis , including guide wire assisted technique,needle knife precutting,trans-pancreatic sphincterotomy,and pancreatic stenting.