title: Editorial: Guidewire Trauma: A Key Component of Post-ERCP Pancreatitis That Is Best Controlled by the Endoscopist.
abstract: Recent studies have revealed that deep pancreatic duct wire passage, even in the absence of contrast injection, is a major technique-related culprit in post-ERCP pancreatitis, unless followed by placement of a pancreatic stent. As guidewire cannulation becomes increasingly widespread, precise control of the guidewire is thus critical. The first randomized trial to compare endoscopist-controlled wire guided vs. assistant-controlled bile duct cannulation has shown a significant reduction in post ERCP pancreatitis when the physician manipulates the wire. Though there is no single universal solution to post-ERCP pancreatitis, careful attention to wire contol is emerging as an important aspect of safety in ERCP.
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, University of Minnesota, Minneapolis, Minnesota, USA.
authors.forename: Indu
authors.initials: I
authors.lastname: Srinivasan
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, University of Minnesota, Minneapolis, Minnesota, USA.
authors.forename: Martin L
authors.initials: ML
authors.lastname: Freeman
mesh_terms: D002404:Catheterization; D002760:Cholangiopancreatography, Endoscopic Retrograde; D006801:Humans; D010183:Pancreatic Ducts; D010195:Pancreatitis; D015607:Stents