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Pancreatic guidewire placement for achieving selective biliary cannulation during endoscopic retrograde cholangio-pancreatography.
World J Gastroenterol 2008; 14(36):5595-600; discussion 5599WJ

Abstract

AIM

To investigate the frequency and risk factors for acute pancreatitis after pancreatic guidewire placement (P-GW) in achieving cannulation of the bile duct during endoscopic retrograde cholangio-pancreatography (ERCP).

METHODS

P-GW was performed in 113 patients in whom cannulation of the bile duct was difficult. The success rate of biliary cannulation, the frequency and risk factors of post-ERCP pancreatitis, and the frequency of spontaneous migration of the pancreatic duct stent were investigated.

RESULTS

Selective biliary cannulation with P-GW was achieved in 73% of the patients. Post-ERCP pancreatitis occurred in 12% (14 patients: mild, 13; moderate, 1). Prophylactic pancreatic stenting was attempted in 59% of the patients. Of the 64 patients who successfully underwent stent placement, three developed mild pancreatitis (4.7%). Of the 49 patients without stent placement, 11 developed pancreatitis (22%: mild, 10; moderate, 1). Of the five patients in whom stent placement was unsuccessful, two developed mild pancreatitis. Univariate and multivariate analyses revealed no pancreatic stenting to be the only significant risk factor for pancreatitis. Spontaneous migration of the stent was observed within two weeks in 92% of the patients who had undergone pancreatic duct stenting.

CONCLUSION

P-GW is useful for achieving selective biliary cannulation. Pancreatic duct stenting after P-GW can reduce the incidence of post-ERCP pancreatitis, which requires evaluation by means of prospective randomized controlled trials.

Authors+Show Affiliations

Department of Gastroenterology, Sendai City Medical Center, 5-22-1 Tsurugaya, Miyagino-ku, Sendai, Miyagi, Japan. keiito@openhp.or.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18810780

Citation

Ito, Kei, et al. "Pancreatic Guidewire Placement for Achieving Selective Biliary Cannulation During Endoscopic Retrograde Cholangio-pancreatography." World Journal of Gastroenterology, vol. 14, no. 36, 2008, pp. 5595-600; discussion 5599.
Ito K, Fujita N, Noda Y, et al. Pancreatic guidewire placement for achieving selective biliary cannulation during endoscopic retrograde cholangio-pancreatography. World J Gastroenterol. 2008;14(36):5595-600; discussion 5599.
Ito, K., Fujita, N., Noda, Y., Kobayashi, G., Obana, T., Horaguchi, J., ... Kanno, Y. (2008). Pancreatic guidewire placement for achieving selective biliary cannulation during endoscopic retrograde cholangio-pancreatography. World Journal of Gastroenterology, 14(36), pp. 5595-600; discussion 5599.
Ito K, et al. Pancreatic Guidewire Placement for Achieving Selective Biliary Cannulation During Endoscopic Retrograde Cholangio-pancreatography. World J Gastroenterol. 2008 Sep 28;14(36):5595-600; discussion 5599. PubMed PMID: 18810780.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pancreatic guidewire placement for achieving selective biliary cannulation during endoscopic retrograde cholangio-pancreatography. AU - Ito,Kei, AU - Fujita,Naotaka, AU - Noda,Yutaka, AU - Kobayashi,Go, AU - Obana,Takashi, AU - Horaguchi,Jun, AU - Takasawa,Osamu, AU - Koshita,Shinsuke, AU - Kanno,Yoshihide, PY - 2008/9/24/pubmed PY - 2008/12/17/medline PY - 2008/9/24/entrez SP - 5595-600; discussion 5599 JF - World journal of gastroenterology JO - World J. Gastroenterol. VL - 14 IS - 36 N2 - AIM: To investigate the frequency and risk factors for acute pancreatitis after pancreatic guidewire placement (P-GW) in achieving cannulation of the bile duct during endoscopic retrograde cholangio-pancreatography (ERCP). METHODS: P-GW was performed in 113 patients in whom cannulation of the bile duct was difficult. The success rate of biliary cannulation, the frequency and risk factors of post-ERCP pancreatitis, and the frequency of spontaneous migration of the pancreatic duct stent were investigated. RESULTS: Selective biliary cannulation with P-GW was achieved in 73% of the patients. Post-ERCP pancreatitis occurred in 12% (14 patients: mild, 13; moderate, 1). Prophylactic pancreatic stenting was attempted in 59% of the patients. Of the 64 patients who successfully underwent stent placement, three developed mild pancreatitis (4.7%). Of the 49 patients without stent placement, 11 developed pancreatitis (22%: mild, 10; moderate, 1). Of the five patients in whom stent placement was unsuccessful, two developed mild pancreatitis. Univariate and multivariate analyses revealed no pancreatic stenting to be the only significant risk factor for pancreatitis. Spontaneous migration of the stent was observed within two weeks in 92% of the patients who had undergone pancreatic duct stenting. CONCLUSION: P-GW is useful for achieving selective biliary cannulation. Pancreatic duct stenting after P-GW can reduce the incidence of post-ERCP pancreatitis, which requires evaluation by means of prospective randomized controlled trials. SN - 1007-9327 UR - https://www.unboundmedicine.com/medline/citation/18810780/Pancreatic_guidewire_placement_for_achieving_selective_biliary_cannulation_during_endoscopic_retrograde_cholangio_pancreatography_ L2 - http://www.wjgnet.com/1007-9327/full/v14/i36/5595.htm DB - PRIME DP - Unbound Medicine ER -