Double-guide wire technique for difficult bile duct cannulation in patients due to biliary complications after liver transplantation / 中华消化内镜杂志

ABSTRACT

Objective To compare the double-guide wire technique (DGT) with the standard cannulation technique (SCT) in patients with difficult access due to biliary complications after liver transplantation.Methods Difficult CBD cannulation is characterized by unsuccessful cannulation in 10 minutes.A total of 91 patients with biliary complications after liver transplantation were assigned to the DGT group (44patients,including 6 difficult cannulation,41 males and 3 females,30 to 61 years) and the SCT group (47patients,41 males and 6 females,33 to 56 years).An extra 20-minute cannulation was performed on the two groups.Success rate,procedure time and complications were compared.Results CBD cannulation was successful in 36 (81.8％) patients of DGT group and 33 (70.2％ ) patients of SCT group,which was not different ( P ＞ 0.05 ).The time of successful CBD cannulation in the DGT group ( 11.7 ± 3.2 minutes) was shorter than that in the SGT group ( 16.8 ±2.8 minutes,P ＜0.05).The incidence of post-ERCP hyperamylnsemia had no difference in the two groups ( P ＞ 0.05 ).There were no serious complications like infection,hemorrhage or perforation in either group.Mild pancreatitis occurred in 2 cases in the SCT group,but none in DGT.Conclusion DGT is an effective and safe technique in patients with biliary complications after liver transplantation,with no more complications than the SCT group.It is recommended in difficult cannulation of common bile duct (CBD).