ObjectiveTo investigate the operation skills of endoscopic retrograde cholangiopancreatography (ERCP) in patients with periampullary duodenal diverticula. MethodsA retrospective analysis was performed for the clinical data of 867 patients with periampullary duodenal diverticula who underwent ERCP in Department of Hepatobiliary Endoscopy in Shandong Jiaotong Hospital from March 2013 to February 2015. The rate of successful intubation, therapeutic effect, and development of complications were analyzed. ResultsThe rate of successful intubation was 99.8%. Of all patients, 793 underwent successful intubation with an incision knife, 44 were treated with double guide wires and pancreatic duct stenting, 3 underwent fixation of the papilla with hemostatic clips, 25 underwent the pre-cut technique, and 2 underwent failed intubation. There were 5 cases of pancreatitis, l case of perforation, l case of delayed bleeding, and all the patients were cured after conservative treatment. ConclusionWhen ERCP is used in the treatment of pancreaticobiliary diseases complicated by periampullary duodenal diverticula, the indications for ERCP and endoscopic sphincterotomy should be clarified. Targeted operation skills selected based on the features of the papilla help to improve the success rate and reduce complications, and therefore, it is a safe minimally invasive therapy.