Guidewire biliary cannulation does not reduce post-ERCP pancreatitis compared with the contrast injection technique in low-risk and high-risk patients

Alberto Mariani; Antonella Giussani; Milena Di Leo; Sabrina Testoni; Pier Alberto Testoni

doi:10.1016/j.gie.2011.09.002

Guidewire biliary cannulation does not reduce post-ERCP pancreatitis compared with the contrast injection technique in low-risk and high-risk patients

Alberto Mariani, Antonella Giussani, Milena Di Leo, Sabrina Testoni, Pier Alberto Testoni

IRCCS Ospedale San Raffaele

Research output: Contribution to journal › Article › peer-review

Abstract

Background: Guidewire (GW) cannulation can reduce the risk of post-ERCP pancreatitis (PEP) by avoiding the opacification of the main pancreatic duct. Objective: To compare the effects of conventional contrast ERCP and GW cannulation of the common bile duct on the rate of PEP in low- and high-risk patients. Design: Prospective, comparative-intervention single-center study. Setting: Tertiary referral center. Patients: Patients with biliary disease with an intact papilla were prospectively examined by ERCP. Interventions: Biliary cannulation using a sphincterotome with contrast injection (ConI) or a hydrophilic GW without contrast injection. Main Outcome Measurements: Pancreatitis rate in the GW group and the contrast injection (ConI) group. Results: PEP occurred in 60 of 1249 patients (4.8%), 35 of 678 (5.2%) in the GW group and 25 of 571 (4.4%) in the ConI group (not significant). The overall rate of PEP was significantly higher in high-risk patients (12.2%) than in low-risk patients (3.5%) (P

Original language	English
Pages (from-to)	339-346
Number of pages	8
Journal	Gastrointestinal Endoscopy
Volume	75
Issue number	2
DOIs	https://doi.org/10.1016/j.gie.2011.09.002
Publication status	Published - Feb 2012

Keywords

acute recurrent pancreatitis
ARP
CBD
CI
common bile duct
confidence interval
ConI
contrast injection
guidewire
GW
main pancreatic duct
MPD
PEP
post-ERCP pancreatitis
SOD
sphincter of Oddi dysfunction

ASJC Scopus subject areas

Gastroenterology
Radiology Nuclear Medicine and imaging

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Guidewire biliary cannulation does not reduce post-ERCP pancreatitis compared with the contrast injection technique in low-risk and high-risk patients. / Mariani, Alberto; Giussani, Antonella; Di Leo, Milena; Testoni, Sabrina; Testoni, Pier Alberto.

In: Gastrointestinal Endoscopy, Vol. 75, No. 2, 02.2012, p. 339-346.

Research output: Contribution to journal › Article › peer-review

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title = "Guidewire biliary cannulation does not reduce post-ERCP pancreatitis compared with the contrast injection technique in low-risk and high-risk patients",

abstract = "Background: Guidewire (GW) cannulation can reduce the risk of post-ERCP pancreatitis (PEP) by avoiding the opacification of the main pancreatic duct. Objective: To compare the effects of conventional contrast ERCP and GW cannulation of the common bile duct on the rate of PEP in low- and high-risk patients. Design: Prospective, comparative-intervention single-center study. Setting: Tertiary referral center. Patients: Patients with biliary disease with an intact papilla were prospectively examined by ERCP. Interventions: Biliary cannulation using a sphincterotome with contrast injection (ConI) or a hydrophilic GW without contrast injection. Main Outcome Measurements: Pancreatitis rate in the GW group and the contrast injection (ConI) group. Results: PEP occurred in 60 of 1249 patients (4.8%), 35 of 678 (5.2%) in the GW group and 25 of 571 (4.4%) in the ConI group (not significant). The overall rate of PEP was significantly higher in high-risk patients (12.2%) than in low-risk patients (3.5%) (P ",

keywords = "acute recurrent pancreatitis, ARP, CBD, CI, common bile duct, confidence interval, ConI, contrast injection, guidewire, GW, main pancreatic duct, MPD, PEP, post-ERCP pancreatitis, SOD, sphincter of Oddi dysfunction",

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