Guide Wire Selection (Straight vs. Angled) in Endoscopic Retrograde Cholangiopancreatography Using a Normal Contrast Catheter Performed by a Trainee: A Single-Center Prospective Randomized Controlled Cross-Over Study

Takumi Maki; Atsushi Irisawa; Akira Yamamiya; Keiichi Tominaga; Yoko Abe; Koh Imbe; Koki Hoshi; Akane Yamabe; Ryo Igarashi; Yuki Nakajima; Kentaro Sato; Goro Shibukawa

doi:10.3390/jcm12082917

Guide Wire Selection (Straight vs. Angled) in Endoscopic Retrograde Cholangiopancreatography Using a Normal Contrast Catheter Performed by a Trainee: A Single-Center Prospective Randomized Controlled Cross-Over Study

J Clin Med. 2023 Apr 17;12(8):2917. doi: 10.3390/jcm12082917.

Authors

Takumi Maki^{1

2

3}, Atsushi Irisawa^{1

3}, Akira Yamamiya³, Keiichi Tominaga³, Yoko Abe^{1

3}, Koh Imbe¹, Koki Hoshi^{1

3}, Akane Yamabe^{1

3}, Ryo Igarashi¹, Yuki Nakajima¹, Kentaro Sato¹, Goro Shibukawa¹

Affiliations

¹ Department of Gastroenterology, Aizu Medical Center, Fukushima Medical University, 21-2 Kawahigashi Aizuwakamatsu, Fukushima 969-3482, Japan.
² Department of Internal Medicine, Minamiaizu Prefectural Hospital, 14-1 Nagata Minamiaizu, Fukushima 967-0006, Japan.
³ Department of Gastroenterology, Dokkyo Medical University School of Medicine, 880 Kitakobayashi Mibu, Tochigi 321-0293, Japan.

Abstract

Introduction: Wire-guided cannulation (WGC) during endoscopic retrograde cholangiopancreatography (ERCP) is a selective biliary cannulation technique aimed at improving the successful selective biliary cannulation rate and reducing the rate of post-ERCP pancreatitis (PEP) incidence. This study aimed to evaluate the effectiveness of angled-tip guidewires (AGW) vs. straight-tip guidewires (SGW) for biliary cannulation via WGC by a trainee.

Methods: We conducted a prospective, single-center, open-labeled, randomized, and controlled trial. Fifty-seven patients were enrolled in this study and assigned randomly to two groups (Group A to S and Group S to A). In this study, we started selective biliary cannulation via WGC with an AGW or an SGW for 7 min. If cannulation was unsuccessful, the other guidewire was used, and cannulation was continued for another 7 min (cross-over method).

Results: The selective biliary cannulation success rate over 14 min was significantly higher with an AGW compared with an SGW over 14 min (57.8% vs. 34.3%, p = 0.04) and for the second 7-min segment (36.4% vs. 0%, p = 0.04). No significant difference was found for adverse events such as pancreatitis between the two guidewires.

Conclusions: Our results suggest that an AGW is recommended for WGC performed by a trainee.

Keywords: endoscopic retrograde cholangiopancreatography; trainee; wire-guided cannulation.

Grants and funding

This research received no external funding.