PA Testoni, S Testoni… - Digestive and Liver Disease, 2011 - Elsevier ... However, advancing the guide-wire into the papilla blindly before having achieved deep cannulation may risk creating a loop with the wire within the ampulla, with consequent tissue oedema or perforation of the supra-papillary caruncula, if the guide-wire does not enter a duct. ... Related articles - All 3 versions