Double guidewire technique vs transpancreatic precut sphincterotomy in difficult biliary cannulation
- Authors
- Yoo, Young Wook; Cha, Sang-Woo; Lee, Woong Cheul; Kim, Sae Hee; Kim, Anna; Cho, Young Deok
- Issue Date
- 7-Jan-2013
- Publisher
- Baishideng Publishing Group
- Keywords
- Endoscopic retrograde cholangiopancreatography; Post-endoscopic retrograde cholangiopancreatography pancreatitis; Duoble guidewire technique; Transpancrestic precut sphincterotomy
- Citation
- World Journal of Gastroenterology, v.19, no.1, pp 108 - 114
- Pages
- 7
- Journal Title
- World Journal of Gastroenterology
- Volume
- 19
- Number
- 1
- Start Page
- 108
- End Page
- 114
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/13979
- DOI
- 10.3748/wjg.v19.i1.108
- ISSN
- 1007-9327
2219-2840
- Abstract
- AIM: To compare the outcomes between double-guidewire technique (DGT) and transpancreatic precut sphincterotomy (TPS) in patients with difficult biliary cannulation. METHODS: This was a prospective, randomized study conducted in single tertiary referral hospital in Korea. Between January 2005 and September 2010. A total of 71 patients, who bile duct cannulation was not possible and selective pancreatic duct cannulation was achieved, were randomized into DGT (n = 34) and TPS (n = 37) groups. DGT or TPS was done for selective biliary cannulation. We measured the technical success rates of biliary cannulation, median cannulation time, and procedure related complications. RESULTS: The distribution of patients after randomization was balanced, and both groups were comparable in baseline characteristics, except the higher percentage of endoscopic nasobiliary drainage in the DGT group (55.9% vs 13.5%, P < 0.001). Successful cannulation rate and mean cannulation times in DGT and TPS groups were 91.2% vs 91.9% and 14.1 +/- 13.2 min vs 15.4 +/- 17.9 min, P = 0.732, respectively. There was no significant difference between the two groups. The overall incidence of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis was 38.2% vs 10.8%, P < 0.011 in the DGT group and the TPS group; post-procedure pancreatitis was significantly higher in the DGT group. But the overall incidence of post-ERCP hyperamylasemia was no significant difference between the two groups; DGT group vs TPS group: 14.7% vs 16.2%, P < 1.0. CONCLUSION: When free bile duct cannulation was difficult and selective pancreatic duct cannulation was achieved, DGT and TPS facilitated biliary cannulation and showed similar success rates. However, post-procedure pancreatitis was significantly higher in the DGT group. (C) 2013 Baishideng. All rights reserved.
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Collections - College of Medicine > Department of Internal Medicine > 1. Journal Articles
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