1. Early double-guidewire versus repeated single-guidewire technique to facilitate selective bile duct cannulation: a randomized controlled trial
- Author
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A. Laquière, Clément Subtil, J Privat, Christian Boustière, Romain Legros, Hichem Belkhodja, David Karsenti, Maria Katsogiannou, Romina Urena-Campos, Jérémie Jacques, L. Lecomte, and Leila Kanafi
- Subjects
Pancreatic duct ,medicine.medical_specialty ,Endoscopic retrograde cholangiopancreatography ,Common bile duct ,medicine.diagnostic_test ,business.industry ,Bile duct ,Gastroenterology ,medicine.disease ,law.invention ,Surgery ,Major duodenal papilla ,medicine.anatomical_structure ,Randomized controlled trial ,law ,Medicine ,Pancreatitis ,In patient ,business - Abstract
Background During endoscopic retrograde cholangiopancreatography (ERCP), access to the common bile duct (CBD) can be problematic after unintentional insertion of the guidewire into the pancreatic duct. We conducted a prospective, randomized study in order to compare biliary cannulation success rates of early double-guidewire (EDG) and repeated single-guidewire (RSG) techniques in patients with inadvertent passage of the guidewire into the pancreatic duct. Methods Patients with a native papilla were randomly assigned to either the EDG or RSG groups after unintentional insertion of the guidewire into the pancreatic duct. The primary outcome was successful selective CBD cannulation within 10 minutes. The secondary outcomes were successful final selective bile duct cannulation, time to bile duct cannulation, and frequency of post-ERCP pancreatitis (PEP). Results 142 patients were randomized and selective bile duct cannulation was achieved in 57/68 patients (84 %) in the EDG group and in 37/74 patients (50 %) in the RSG group within 10 minutes (relative risk 1.34; 95 % confidence interval 1.08–6.18; P Conclusion The EDG technique significantly increased the success rate of biliary duct cannulation within 10 minutes compared with an RSG approach.
- Published
- 2021