title: Guide-wire versus conventional contrast cannulation of the common bile duct for the prevention of post-ERCP pancreatitis in patients with choledocholithiasis.
abstract: BACKGROUND
  Inadvertent injection of a contrast agent into the pancreatic duct is an important contributor factor to post-ERCP pancreatitis.
  
  
  OBJECTIVE
  To compare the incidence of post-ERCP pancreatitis and the success rate of biliary cannulation using guide-wire cannulation or the standard contrast injection technique.
  
  
  METHODS
  A total of 128 patients with choledocholithiasis who underwent either guide-were cannulation (n=70) or contrast injection (n=58) were retrospectively reviewed. Outcome measurements were post-ERCP pancreatitis and rate of successful common bile duct (CBD) cannulation.
  
  
  RESULTS
  Three patients (4.3%) in the guide-wire cannulation group and five patients (8.6%) in the contrast injection group had post-ERCP pancreatitis (p>0.05). Successful CBD cannulation was achieved in 91.4% with guide-wire cannulation and in 88% with conventional contrast cannulation (p>0.05).
  
  
  CONCLUSIONS
  Our study failed to show significant reduction in the rate of post-ERCP pancreatitis with the use of guide-wire, although there was a downward trend. The success rate of cannulation was comparable between the two techniques.
authors: University of Medicine and Pharmacy Gr.T. Popa, Institute of Gastroenterology and Hepatology, Iasi, Romania. ancatrifan@yahoo.com
authors: Anca
authors: A
authors: Trifan
authors: Catalin
authors: C
authors: Sfarti
authors: Maria
authors: M
authors: Cretu
authors: Camelia
authors: C
authors: Cojocariu
authors: Catalin
authors: C
authors: Hutanasu
authors: Ana-Maria
authors: AM
authors: Singeap
authors: Mihaela
authors: M
authors: Dimache
authors: Carol
authors: C
authors: Stanciu
mesh_terms: D000328:Adult; D000368:Aged; D002404:Catheterization / Q000379:methods*; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects*; D042883:Choledocholithiasis / Q000601:surgery*; D003135:Common Bile Duct; D003287:Contrast Media / Q000008:administration & dosage; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000209:etiology / Q000517:prevention & control*; D011183:Postoperative Complications; D012189:Retrospective Studies; D016717:Sphincterotomy, Endoscopic; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media