Clinical value of double guidewire technique for perforation of duodenal papilla by guidewire in endoscopic retrograde cholangiopancreatography / 中华消化内镜杂志

ABSTRACT

Objective To evaluate the efficacy and safety of double guidewire technique in perforation of duodenal papilla caused by guide wire during endoscopic retrograde cholangiopancreatography ( ERCP ) intubation. Methods A retrospective analysis was performed on data of 57 patients whose duodenal papilla were perforated by guidewire in ERCP from January 2008 to September 2016. Among the 57 patients, 30 patients were cannulated with double guidewire technique ( double guidewire group ) and 27 patients were performed with traditional technique ( standard group ) for continue. The biliary intubation success rate, intubation time, and post-ERCP complication rate were compared between the two groups. Results The rate of successful intubation of the double guidewire group was significantly higher than that of the standard group[96. 7％ (29/30) VS 74. 1％ (20/27),χ2=5. 545, P=0. 019]. The intubation time of the double guidewire group was significantly shorter than that of the standard group (21. 8±7. 8 min VS 40. 7 ±8. 4 min, t=8. 076, P=0. 000). The double guidewire group had a similar incidence of post-ERCP complication compared to the standard group[ 13. 3％ ( 4/30) VS 11. 1％ ( 3/27) ,χ2=0. 292, P=0. 596] , and the complication in two groups was hyperamylasemia. Conclusion Double guidewire technique is safe and effective for difficult biliary cannulation because of perforation of duodenal papilla with a higher success rate and less time compared to classic technique.