title: Prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis by pancreatic duct stenting using a loop-tipped guidewire.
abstract: OBJECTIVE
  To examine whether it is possible to prevent the occurrence of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis in patients experiencing difficulties with selective biliary duct cannulation by pancreatic duct stenting using a loop-tipped guidewire.
  
  
  METHODS
  Procedure success rate, frequency of unintended insertion of the guidewire into side branches of the pancreatic duct, and incidence of procedural accidents were examined using a loop-tipped guidewire (Group A, 20 patients), and a conventional straight-type guidewire (Group B, 20 patients).
  
  
  RESULTS
  The success rate of the procedure was 100% in both groups. Unintended insertion of the guidewire into a side branch of the pancreatic duct occurred 0.056 ± 0.23 (0-1) times in Group A and 2.3 ± 1.84 (0-5) times in Group B; thus, unintended insertion of the guidewire into a side branch of the pancreatic duct was seen significantly less frequently in Group A. There were no procedural accidents in Group A, whereas pancreatitis occurred in one Group B patient; however, the difference between the two groups was not statistically significant. The serum amylase level after ERCP was 257.15 ± 136.4 (88-628) IU/L in Group A, and 552.05 ± 534.57 (101-2389) IU/L in Group B, showing a significantly lower value in Group A. Hyperamylasemia was found in two patients (10%) in Group A, and nine (45%) in Group B, showing a significantly lower value in Group A.
  
  
  CONCLUSIONS
  The results suggest that in patients who experience difficulties with biliary cannulation, the use of a loop-tipped guidewire for pancreatic duct stenting may assist with the prevention of post-ERCP pancreatitis, and thereby to a reduction of the risk of post-ERCP pancreatitis or hyperamylasemia.
authors: Yuji Sakai, Toshio Tsuyuguchi, Harutoshi Sugiyama, Masahiro Hayashi, Jun-ichi Senoo, Reina Sasaki, Yuko Kusakabe, Masato Nakamura, Shin Yasui, Rintaro Mikata, Osamu Yokosuka, Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba City 260-8670, Japan.
authors: Yuji
authors: Y
authors: Sakai
authors: Yuji Sakai, Toshio Tsuyuguchi, Harutoshi Sugiyama, Masahiro Hayashi, Jun-ichi Senoo, Reina Sasaki, Yuko Kusakabe, Masato Nakamura, Shin Yasui, Rintaro Mikata, Osamu Yokosuka, Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba City 260-8670, Japan.
authors: Toshio
authors: T
authors: Tsuyuguchi
authors: Yuji Sakai, Toshio Tsuyuguchi, Harutoshi Sugiyama, Masahiro Hayashi, Jun-ichi Senoo, Reina Sasaki, Yuko Kusakabe, Masato Nakamura, Shin Yasui, Rintaro Mikata, Osamu Yokosuka, Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba City 260-8670, Japan.
authors: Harutoshi
authors: H
authors: Sugiyama
authors: Yuji Sakai, Toshio Tsuyuguchi, Harutoshi Sugiyama, Masahiro Hayashi, Jun-ichi Senoo, Reina Sasaki, Yuko Kusakabe, Masato Nakamura, Shin Yasui, Rintaro Mikata, Osamu Yokosuka, Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba City 260-8670, Japan.
authors: Masahiro
authors: M
authors: Hayashi
authors: Yuji Sakai, Toshio Tsuyuguchi, Harutoshi Sugiyama, Masahiro Hayashi, Jun-ichi Senoo, Reina Sasaki, Yuko Kusakabe, Masato Nakamura, Shin Yasui, Rintaro Mikata, Osamu Yokosuka, Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba City 260-8670, Japan.
authors: Jun-Ichi
authors: J
authors: Senoo
authors: Yuji Sakai, Toshio Tsuyuguchi, Harutoshi Sugiyama, Masahiro Hayashi, Jun-ichi Senoo, Reina Sasaki, Yuko Kusakabe, Masato Nakamura, Shin Yasui, Rintaro Mikata, Osamu Yokosuka, Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba City 260-8670, Japan.
authors: Reina
authors: R
authors: Sasaki
authors: Yuji Sakai, Toshio Tsuyuguchi, Harutoshi Sugiyama, Masahiro Hayashi, Jun-ichi Senoo, Reina Sasaki, Yuko Kusakabe, Masato Nakamura, Shin Yasui, Rintaro Mikata, Osamu Yokosuka, Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba City 260-8670, Japan.
authors: Yuko
authors: Y
authors: Kusakabe
authors: Yuji Sakai, Toshio Tsuyuguchi, Harutoshi Sugiyama, Masahiro Hayashi, Jun-ichi Senoo, Reina Sasaki, Yuko Kusakabe, Masato Nakamura, Shin Yasui, Rintaro Mikata, Osamu Yokosuka, Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba City 260-8670, Japan.
authors: Masato
authors: M
authors: Nakamura
authors: Yuji Sakai, Toshio Tsuyuguchi, Harutoshi Sugiyama, Masahiro Hayashi, Jun-ichi Senoo, Reina Sasaki, Yuko Kusakabe, Masato Nakamura, Shin Yasui, Rintaro Mikata, Osamu Yokosuka, Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba City 260-8670, Japan.
authors: Shin
authors: S
authors: Yasui
authors: Yuji Sakai, Toshio Tsuyuguchi, Harutoshi Sugiyama, Masahiro Hayashi, Jun-ichi Senoo, Reina Sasaki, Yuko Kusakabe, Masato Nakamura, Shin Yasui, Rintaro Mikata, Osamu Yokosuka, Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba City 260-8670, Japan.
authors: Rintaro
authors: R
authors: Mikata
authors: Yuji Sakai, Toshio Tsuyuguchi, Harutoshi Sugiyama, Masahiro Hayashi, Jun-ichi Senoo, Reina Sasaki, Yuko Kusakabe, Masato Nakamura, Shin Yasui, Rintaro Mikata, Osamu Yokosuka, Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba City 260-8670, Japan.
authors: Masaru
authors: M
authors: Miyazaki
authors: Yuji Sakai, Toshio Tsuyuguchi, Harutoshi Sugiyama, Masahiro Hayashi, Jun-ichi Senoo, Reina Sasaki, Yuko Kusakabe, Masato Nakamura, Shin Yasui, Rintaro Mikata, Osamu Yokosuka, Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba City 260-8670, Japan.
authors: Osamu
authors: O
authors: Yokosuka
keywords: Guidewire; Hyperamylasemia; Post-endoscopic retrograde cholangiopancreatography pancreatitis