A prospective randomized trial of cannulation technique in ERCP: effects on technical success and post-ERCP pancreatitis

Abstract

The guide-wire technique improves the primary success rate for biliary cannulation during ERCP but does not reduce the incidence of PEP compared to the conventional contrast technique. The incidence of PEP increases incrementally with each attempt at the papilla.

Risks of transesophageal endoscopic ultrasonography-guided biliary drainage

“…Although these advanced techniques have increased the success rate of deep cannulation to as high as 97% to 98.5%, the procedure is still not perfect. [1][2][3] The development of a linear array ultrasound endoscope has enabled various procedures of endoscopic ultrasonography-guided BD (EUS-BD). EUS-BD was reported for the first time in 2001 4 and is now developing alternative to percutaneous transhepatic BD and surgery in patients in whom ERCP has failed.…”

Prevention of Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis

“…However, several prospective studies (50)(51)(52) provided conflicting results as to whether the wire-guided cannulation technique reduces PEP risk compared with the standard method. Further RCTs are needed to confirm the effectiveness of this method.…”

Advances in endoscopic retrograde cholangiopancreatography cannulation

“…The guide wire technique for bile duct cannulation may lower the likelihood of postERCP pancreatitis (PEP) compared to the contrast injection methods by avoiding unintentional pancreatic duct injection and reducing the need for precut sphincterotomy [4,10,11] . However, a conflicting study found no difference in the incidence of PEP and suggested that successful cannulation with fewer attempts at the papilla is a more important factor than whether guide wire or contrast is routinely used first to achieve biliary cannulation [12] . It was also reported that using a hydrophilic guide wire achieves a higher rate of selective CBD cannulation compared to a standard ERCP catheter but the complication rates including PEP were similar in both groups [13] .…”