title: The utility of upfront double wire guided biliary cannulation following early unintentional pancreatic cannulation in patients undergoing ERCP.
abstract: This study aims to assess the impact of upfront double-guidewire technique (DGT) following inadvertent early pancreatic duct (PD) cannulation or biliary cannulation and post-endoscopic retrograde cholangiopancreatography (ERCP) complications. A pilot non-randomized cohort study was performed in patients undergoing ERCP. DGT was utilized in the first 25 patients followed by standard cannulation technique (SCT) in the subsequent 25. A significantly lower PD cannulation rate [median (range)] was noted in the DGT group [1 (0-5) vs. 3 (0-6); p=0.013]; however, the pancreatitis rate was similar [2 (9 %) DGT, 1 (4 %) SCT; p=0.601]. In the SCT group, 15/25 (60 %) required DGT to achieve biliary cannulation. The majority of our cohort proceeding to an SCT following early PD cannulation required a DGT to achieve biliary cannulation. Early DGT resulted in a significant reduction in unintentional pancreatic cannulation but did not translate into a reduction in pancreatitis in our cohort.
authors: Department of Gastroenterology, Austin Health, University of Melbourne, Heidelberg, Melbourne, Victoria, Australia.
authors: Sujievvan
authors: S
authors: Chandran
authors: Mehrdad
authors: M
authors: Nikfarjam
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001652:Bile Ducts; D002404:Catheterization / Q000379:methods*; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010183:Pancreatic Ducts; D010195:Pancreatitis / Q000209:etiology
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