Double guidewire technique for ERCP in difficult bile cannulation Experience with 121 cases

Abstract

AIM: The aim of this study is to report our experience using double guide-wire technique (DGT) for biliary cannulation.

MATERIAL OF STUDY: From 2007 to 2010, out of 1607 consecutive patients undergoing ERCP with the intent to cannulate the common bile duct (CBD) 1335 were considered suitable for this study. In 131 of these patients deep biliary cannulation with standard cannulation technique (SCT) failed. In these cases DGT was attempted.

RESULTS: DGT could be used in 121 patients with success rate of deep biliary cannulation in 117 (96.7%) with a 2.6% rate post ERCP pancreatitis.

DISCUSSION: Since difficulties in selective cannulation are sometimes encountered due to anatomical constraints or papillary spasm, pharmacologic aids and other non invasive methods such as papillotome cannulation or guidewire cannulation are used. DGT consented a high rate of successful selective biliary cannulation with a low rate of complications.

CONCLUSION: According to our experience we can concluded, that in expert hands, the double guidewire technique (DGT) can be considered useful and safe method in difficult biliary cannulation, reducing the need of more invasive technique such as precut papillotomy.