BACKGROUND: Deep biliary cannulation (DBC) is a prerequisite to most endoscopic retrograde cholangiopancreatographies (ERCPs). Numerous techniques have been described to maximize success and minimize ERCP-related complications, most notably post-ERCP pancreatitis. Dye-free cannulation by using guidewires with hydrophilic tips has been proposed as a technique with a high rate of success and a low rate of complications. We report the outcomes 822 consecutive ERCP procedures by using dye-free guidewire cannulation techniques. OBJECTIVE: To evaluate the success rate for DBC and rates of complications by using dye-free guidewire cannulation techniques. DESIGN: Retrospective. Consecutive ERCP procedures with intent to achieve DBC exclusively by using dye-free guidewire technique were included. Complication data on post-ERCP pancreatitis, bleeding, perforation, and cholangitis were extracted. SETTING: University. PATIENTS: Patients undergoing biliary ERCP. INTERVENTIONS: ERCP. MAIN OUTCOME MEASUREMENTS: Success, complication rates. RESULTS: Eight hundred and twenty-two ERCPs were performed on 744 patients. Five hundred and fifty-nine (68%) procedures were performed on inpatients, 263 (32%) on outpatients. DBC was successful in 801 of 822 (97%) ERCPs. In 795 of 801 (99%) ERCPs with successful DBC procedures, DBC was achieved in a dye-free fashion. Eleven patients (1.3%) developed post-ERCP pancreatitis-all cases were mild. Guidewire perforations occurred 11 times (1.3%), none required surgery. Ten of 11 patients with known or suspected (91%) guidewire perforation achieved successful DBC on repeat ERCP by the same endoscopist by using dye-free techniques. LIMITATIONS: Retrospective. CONCLUSIONS: In this large retrospective case series, a high success rate of DBC was achieved by using dye-free guidewire techniques. This technique has associated lower rates of complications in comparison to those reported earlier.
BACKGROUND: Deep biliary cannulation (DBC) is a prerequisite to most endoscopic retrograde cholangiopancreatographies (ERCPs). Numerous techniques have been described to maximize success and minimize ERCP-related complications, most notably post-ERCP pancreatitis. Dye-free cannulation by using guidewires with hydrophilic tips has been proposed as a technique with a high rate of success and a low rate of complications. We report the outcomes 822 consecutive ERCP procedures by using dye-free guidewire cannulation techniques. OBJECTIVE: To evaluate the success rate for DBC and rates of complications by using dye-free guidewire cannulation techniques. DESIGN: Retrospective. Consecutive ERCP procedures with intent to achieve DBC exclusively by using dye-free guidewire technique were included. Complication data on post-ERCP pancreatitis, bleeding, perforation, and cholangitis were extracted. SETTING: University. PATIENTS: Patients undergoing biliary ERCP. INTERVENTIONS: ERCP. MAIN OUTCOME MEASUREMENTS: Success, complication rates. RESULTS: Eight hundred and twenty-two ERCPs were performed on 744 patients. Five hundred and fifty-nine (68%) procedures were performed on inpatients, 263 (32%) on outpatients. DBC was successful in 801 of 822 (97%) ERCPs. In 795 of 801 (99%) ERCPs with successful DBC procedures, DBC was achieved in a dye-free fashion. Eleven patients (1.3%) developed post-ERCP pancreatitis-all cases were mild. Guidewire perforations occurred 11 times (1.3%), none required surgery. Ten of 11 patients with known or suspected (91%) guidewire perforation achieved successful DBC on repeat ERCP by the same endoscopist by using dye-free techniques. LIMITATIONS: Retrospective. CONCLUSIONS: In this large retrospective case series, a high success rate of DBC was achieved by using dye-free guidewire techniques. This technique has associated lower rates of complications in comparison to those reported earlier.
Authors: Serge A Sorser; David S Fan; Emily E Tommolino; Roberto M Gamara; Kristen Cox; Ben Chortkoff; Douglas G Adler Journal: Dig Dis Sci Date: 2013-11-08 Impact factor: 3.199
Authors: Douglas G Adler; John G Lieb; Jonathan Cohen; Irving M Pike; Walter G Park; Maged K Rizk; Mandeep S Sawhney; James M Scheiman; Nicholas J Shaheen; Stuart Sherman; Sachin Wani Journal: Am J Gastroenterol Date: 2014-12-02 Impact factor: 10.864
Authors: Anthony T DeBenedet; B Joseph Elmunzer; Sean T McCarthy; Grace H Elta; Philip S Schoenfeld Journal: Am J Gastroenterol Date: 2013-07-23 Impact factor: 10.864