ABSTRACT
Objective To investigate the feasibility and application scope of the looping technique by using a gooseneck snare and a loach guide wire in retrieving tubular foreign bodies within the vascular or ureteral duct. Methods During the period from July 2009 to Dec. 2013, six patients with ruptured catheter were admitted to authors’ hospital. All six patients were females. Three patients had internal ruptured peripherally inserted central venous catheter (PICC), one patient had ruptured implantable venous access port catheter and two patients had replacement of double “J” ureteral catheter stent. By using looping technique, i.e. a loach guide wire and a gooseneck snare were separately placed at the two ends of the tubular foreign body, then the gooseneck snare entangled the soft leading end of the loach guide wire to form a annular structure to seize the ruptured tubular catheter and then to pull it out of the body. Results With the help of the looping technique, the internal ruptured catheter or the double “J” ureteral catheter was successfully removed in all the six patients. Conclusion For the retrieval of the tubular foreign bodies within the vascular or ureteral duct, the looping technique by using a gooseneck snare and a loach guide wire is an effective and fast treatment. Therefore, this technique should be recommended in the clinical practice.
ABSTRACT
Objective To observe the comparison of two different guide wire in endoscopic retrograde cholangiopancreatography (ERCP).Methods One hundred and twenty-four patients who were identified with ERCP indications were divided into the loach guide wire group (group A) and zebra guide wire group (group B) by random digits table,each with 62 cases.Intubation time,rate of successful intubation and postoperative complication was compared.Results The rate of of one-time successful intubation in group A was 95.2％(59/62),significantly higher than that in group B [82.3％(51/62)] (P ＜0.05).The average time of one-time successful intubation in group A was (1.38 ± 0.52) min,significantly lower than that in group B [(1.63 ± 0.61) min] (P ＜ 0.05).The rate of total successful intubation in group A was 95.2％(59/62),in group B was 96.8％(60/62),there was no significant difference (P＞ 0.05).The rate of postoperative hyperamylasemia and pancreatitis in group A was 12.9％ (8/62),in group B was 32.3％ (20/62),there was significant difference (P ＜ 0.05).Conclusion The application of the loach guide wire in ERCP operation is significantly better than that of the zebra guide.
ABSTRACT
Objective To compare curve-tip angiography guide wire (loach guide wire) and ultrasmooth hydrophilic guide wire (zebra guide wire) in selective common bile duct (CBD) cannulation of endoscopic retrograde cholangiopancreatography (ERCP). Methods A total of 196 patients were randomly assigned to loach guide wire group to receive cannulation guided by loach guide wire first ( n = 98 ) and zebra guide wire group to use zebra guide wire first ( n =98). If cannulation was not successful after 10 minutes, a further attempt was made for an additional 10 minutes using the alternative guide wire. If still not successful after 10 minutes, other cannulation accessories would be used. The primary and overall selective cannulation time, success rate, and post-procedure abdominal pain and serum amylase were assessed. Results The primary success rate of selective CBD cannulation was higher in the loach guide wire group (93.9%) than that in zebra guide wire group (86. 7%, P ＜0. 05), while there was no significant difference in cannulation time between 2 groups (P ＞ 0. 05 ). The cannulation success rate after crossover was higher in loach guide wire group (76. 9% ) than that in zebra guide wire group (0. 0%, P ＜0. 05). There was no significant difference in post-procedure serum amylase or occurrence rate of post ERCP pancreatitis between 2 groups (P ＞ 0. 05 ).Conclusion Loach guide wire is superior to zebra guide wire in ERCP selective CBD cannulation, which can replace zebra guide wire in difficult cannulation.