0.025-inch<i>vs</i>0.035-inch guide wires for wire-guided cannulation during endoscopic retrograde cholangiopancreatography: A randomized study

Kitamura, Katsuya; Yamamiya, Akira; Ishii, Yu; Satô, Yoshiki; Iwata, Takeo; Nomoto, Tomohiro; Ikegami, Akitoshi; Yoshida, Hitoshi

doi:10.3748/wjg.v21.i30.9182

Cited by 25 publications

(17 citation statements)

References 30 publications

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“…2b ). One study used prophylactic gabexate mesylate for prevention of PEP in all patients 15 . The results did not differ when this study was eliminated (8.3 % vs. 7.1 %, RR: 1.17, CI: 0.73–1.90, P = 0.51, I 2 = 0 %).…”

Section: Resultsmentioning

confidence: 99%

“…The details of the study are highlighted in ▶ Table 1. Only one study included cases of acute gallstone pancreatitis and chronic pancreatitis [13] and only one study included cases of pancreatic cancer [15]. All studies excluded patients with altered anatomy such as (Billroth-II and Roux-En-Y) and previous sphincterotomy for any reason.…”

Section: Study Details and Demographicsmentioning

confidence: 99%

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Impact of guidewire caliber on ERCP outcomes: Systematic review and meta-analysis comparing 0.025- and 0.035-inch guidewires

et al. 2022

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Introduction The impact of guidewire caliber on ERCP outcomes are not clear. Recent studies have compared two guidewires, 0.035” and 0.025” in randomized controlled trials (RCTs). We performed a systematic review and meta-analysis of available RCTs to assess if different caliber would change the outcomes in ERCP. Methods A systematic search of PubMed/Medline, Embase, Cochrane, SciELO, Global Index Medicus and Web of Science was undertaken through November 23rd, 2021 to identify relevant RCTs comparing the two guidewires. Binary variables were compared using random effects model and DerSimonian-Laird approach. For each outcome, risk-ratio (RR), 95% confidence interval (CI), and p-values were generated. A p-value <0.05 was considered significant. Results A total of 3 RCTs with 1079 patients (556 in 0.035” group and 523 in 0.025” group) were included. The primary biliary cannulation was similar in both groups (RR: 1.02, CI: 0.96 – 1.08, p = 0.60). The overall rates of PEP were also similar between the two groups (RR: 1.15, CI: 0.73 – 1.81, p = 0.56). Other outcomes (overall cannulation rate, cholangitis, perforation, bleeding, use of adjunct techniques) were also comparable. Conclusion The results of our analysis did not demonstrate a clear benefit of using one guidewire over other. The endoscopist should consider using the guidewire based on his technical skills and convenience.

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Section: Resultsmentioning

confidence: 99%

Section: Study Details and Demographicsmentioning

confidence: 99%

Impact of guidewire caliber on ERCP outcomes: Systematic review and meta-analysis comparing 0.025- and 0.035-inch guidewires

et al. 2022

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“…Wire-guided cannulation is beneficial regarding PEP risk (RR 0.51), cannulation success (RR 1.07), and need for precutting (RR 0.75) compared to nonwire-guided cannulation techniques including opacification [27]. The diameter of the guidewire (0.035 vs. 0.025 inch) is not a relevant factor for cannulation success [28]. The tip should be hydrophilic to facilitate the passage of the typically S-shaped segment of the CBD.…”

Section: Factors Favoring Cannulation Successmentioning

confidence: 99%

Biliary Cannulation in Endoscopic Retrograde Cholangiography: How to Tackle the Difficult Papilla

Winkel¹,

Schirra²,

Schulz³

et al. 2021

Dig Dis

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Background: In the setting of a naïve papilla, biliary cannulation is a key step in successfully performing endoscopic retrograde cholangiography (ERC). Difficult biliary cannulation (DBC) is associated with an increased risk of post-ERCP-pancreatitis and failure of the whole procedure. Summary: Recommendations for biliary cannulation can be divided in (a) measures to reduce the likelihood of a difficult papilla-situation a priori and (b) rescue techniques in case the endoscopist is actually facing DBC. (a): careful inspection of the papillary anatomy and optimizing its accessibility by scope-positioning is fundamental. A sphincterotome in combination with a soft-tip hydrophilic guide-wire rather than a standard catheter with a standard guide-wire should be used. (b): The most important rescue techniques are needle-knife precut, double-guidewire technique and transpancreatic sphincterotomy. In few cases, anterograde techniques are needed. To this regard, the EUS-guided biliary drainage (EUS-BD) followed by rendezvous is increasingly used as an alternative to percutaneous-transhepatic biliary drainage. Key Messages: Biliary cannulation can be accomplished with alternative retrograde or less frequently by salvage-anterograde techniques, once conventional direct cannulation attempts have failed. Considering recent favorable data for the early use of transpancreatic sphincterotomy, an adopted version of the 2016 European-Society-for-Gastrointestinal-Endoscopy (ESGE)-algorithm on biliary cannulation is proposed.

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“…21 However, the use of other guidewire diameters ranging from 0.018 to 0.035 inches may also be used, with two studies finding no difference in cannulation rate between the use of a 0.035 inch and 0.025 inch guidewire. 22,23 Guidewires also come with various tip options, e.g., different shapes. One RCT found no difference in biliary cannulation rate between the use of a straight or angled-tip guidewire, though cannulation time appeared to be shorter with the use of an angled guidewire (20 versus 63 sec; p=0.01).…”

Section: Guidewire-assisted Cannulationmentioning

confidence: 99%

Difficult Biliary Cannulation in Endoscopic Retrograde Cholangiopancreatography: Definitions, Risk Factors, and Implications

2021

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Over the past 50 years, endoscopic retrograde cholangiopancreatography (ERCP) has become the preferred minimally invasive method of treating a vast array of pancreatobiliary diseases. An initial sine qua non for ERCP success is selective ductal cannulation. Despite significant progress in the optimisation of ERCP methods and accessories, selective biliary cannulation using conventional techniques remains unsuccessful in approximately 15% of native papilla cases. Furthermore, difficult biliary cannulation has been associated with an increased risk of post-ERCP pancreatitis, among other adverse events. Here, in the first of a two-part series, the authors provide a primer on standard biliary cannulation techniques and discuss the definition, risk factors, and implications of difficult biliary cannulation. The second part of the series will provide an overview of the existing advanced techniques used in cases of difficult biliary cannulation as well as the approach to their selection.

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0.025-inchvs0.035-inch guide wires for wire-guided cannulation during endoscopic retrograde cholangiopancreatography: A randomized study

Abstract: The thickness of the GW for WGC does not appear to affect either the success rate of selective bile duct cannulation or the incidence of PEP.

Cited by 25 publications

References 30 publications

Impact of guidewire caliber on ERCP outcomes: Systematic review and meta-analysis comparing 0.025- and 0.035-inch guidewires

Impact of guidewire caliber on ERCP outcomes: Systematic review and meta-analysis comparing 0.025- and 0.035-inch guidewires

Biliary Cannulation in Endoscopic Retrograde Cholangiography: How to Tackle the Difficult Papilla

Difficult Biliary Cannulation in Endoscopic Retrograde Cholangiopancreatography: Definitions, Risk Factors, and Implications

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