Prospective Randomized Pilot Trial of Selective Biliary Cannulation Using Pancreatic Guide-Wire Placement

Maeda, S.; Hayashi, Hiroaki; Hasegawa, Osamu; Dohden, Kenji; Hattori, Masahiro; Morita, Mitsuya; Kidani, E.; Ibe, Naoyuki; Tatsumi, Shunichi

doi:10.1055/s-2003-41576

Cited by 133 publications

(141 citation statements)

References 5 publications

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“…Pancreatic duct stenting was not used in this study but there were no cases of post ERCP pancreatitis in either group. The pancreatic duct guide wire group had more hyperamylasemia compared to the conventional group but no patients had abdominal pain [35] . A more recent randomized controlled trial compared the pancreatic duct guide wire technique and standard cannulation technique in 188 patients with difficult CBD cannulation [38] .…”

Section: Pancreatic Techniquesmentioning

confidence: 84%

“…This stabilizes the ampulla of Vater and strai ghtens the terminal common bile duct. After withdrawal of the cannula, the guide wire is left in the pancreatic duct and is monitored by fluoroscopy [35] . The cannula is then reinserted next to the guide wire and cannulation of the bile duct is attempted [37] .…”

Section: Pancreatic Techniquesmentioning

confidence: 99%

“…The rate of pancreatitis was lower in patients who underwent prophylactic pancreatic stenting (4.7%) compared to those who did not (22%) [36] . In a later study of 107 patients undergoing ERCP, selective biliary cannulation was difficult in 53 patients (unsuccessful after 10 min) and these patients were randomly assigned to either preinsertion of a guide wire into the pancreatic duct or persistent attempts with a conventional catheter [35] . In the pancreatic duct guide wire group (n = 27), the success rate was significantly higher than in the conventional group (93% vs 58%).…”

Section: Pancreatic Techniquesmentioning

confidence: 99%

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Advances in endoscopic retrograde cholangiopancreatography cannulation

Qayed

Reid²,

Willingham³

et al. 2010

WJGE

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Endoscopic retrograde cholangiopancreatography is an important tool in the diagnosis and treatment of pancreatobiliary diseases. A critical step in this pro cedure is deep cannulation of the bile duct as failure of cannulation generally results in an aborted procedure and failed intervention. Expert endoscopists usually achieve a high rate of successful cannulation while those less experienced typically have a much lower rate and a greater incidence of complications. Prolonged attempts at cannulation can result in significant morbidity to patients, anxiety for endoscopists, unnecessary radiation exposure and inefficient patient care. Here we review the most common endoscopic techniques used to achi eve selective biliary cannulation. Pharmacologic aids to cannulation are also discussed briefly in this review.

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Section: Pancreatic Techniquesmentioning

confidence: 84%

Section: Pancreatic Techniquesmentioning

confidence: 99%

Section: Pancreatic Techniquesmentioning

confidence: 99%

See 1 more Smart Citation

Advances in endoscopic retrograde cholangiopancreatography cannulation

Qayed

Reid²,

Willingham³

et al. 2010

WJGE

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show abstract

“…11,29,31 In situations where biliary cannulation is difficult and repeated pancreatic cannulation occurs, some experts advocate a double guidewire technique (DGWT) to increase success. [39][40][41][42] There are, however, reports of increased PEP with DGWT 43,44 and the risk is considerably higher (20%-30%) when pancreatic stents are not placed for prophylaxis (see below). A Japanese multicenter study reported that the risk of PEP (11%-32%) with the DGWT was directly correlated with the number of inadvertent pancreatic duct guidewire cannulations (GWCs).…”

Section: Procedures Factorsmentioning

confidence: 99%

Endoscopic retrograde cholangiopancreatography complications: Techniques to reduce risk and management strategies

Tarnasky

Kedia

2017

Int J Gastrointest Interv

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Adverse events after endoscopic retrograde cholangiopancreatography (ERCP) are not uncommon and can be associated with tragic outcomes. Bleeding, perforation, and post-ERCP pancreatitis are the most common complications. Some events are unavoidable; others are associated with well described risk factors so that they can be either anticipated and/or measures can be taken for prevention or at least risk reduction. This review will focus on the more common complications after ERCP, their risk factors, and potential strategies for risk reduction. Additionally, recommendations for management of ERCP complications will be presented.

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“…Double wire use is helpful in cannulation of the common bile duct. Pancreatic duct guidewire placement can be used to facilitate cannulation into the choledochus portion of the common bile duct by maintenance of orientation for the endoscopist [13][14][15] . A major advantage of the short-wire system is the potential for shorter procedure and fluoroscopy time.…”

Section: Reddy Sc Et Al Ercp and Guidewiresmentioning

confidence: 99%

ERCP wire systems: The long and the short of it

Reddy¹,

Draganov²

2009

WJG

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Guidewires are routinely used at the time of endoscopic retrograde cholangiopancreatography (ERCP) to gain and maintain access to the desired duct and aid in the advancement of various devices. Limitations of the traditional long-wire systems have led to the introduction of three proprietary short-wire systems. These systems differ in many respects but share two main principles: They lock a shorter wire in position to allow advancement or removal of various devices without displacement of the wire and they all allow for physician control of the wire. In this comprehensive review, we describe the key features of the three currently available short-wire systems: RX, Fusion and V systems. We also focus on the potential benefits and drawbacks that accompany the short-wire concept as a whole and each specific system in particular. Although the available data are limited, it appears that the use of the short-wire systems lead to reduced procedure, fluoroscopy and device exchange times, decreased sedation requirements, improved wire stability and increased endoscopist control of the wire. Furthermore, the physician-controlled wire-guided cannulation has the potential to decrease ampullary trauma and the rate of post-ERCP pancreatitis. The short guidewire systems appear to be an improvement over the traditional long-wire systems but further studies directly comparing the two approaches are needed.

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Prospective Randomized Pilot Trial of Selective Biliary Cannulation Using Pancreatic Guide-Wire Placement

Cited by 133 publications

References 5 publications

Advances in endoscopic retrograde cholangiopancreatography cannulation

Advances in endoscopic retrograde cholangiopancreatography cannulation

Endoscopic retrograde cholangiopancreatography complications: Techniques to reduce risk and management strategies

ERCP wire systems: The long and the short of it

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