Endoscopy 2003; 35(9): 721-724
DOI: 10.1055/s-2003-41576
Original Article
© Georg Thieme Verlag Stuttgart · New York

Prospective Randomized Pilot Trial of Selective Biliary Cannulation Using Pancreatic Guide-Wire Placement

S.  Maeda1 , H.  Hayashi 1 , O.  Hosokawa 1 , K.  Dohden 1 , M.  Hattori 1 , M.  Morita 1 , E.  Kidani 1 , N.  Ibe 2 , S.  Tatsumi 2
  • 1 Dept. of Surgery
  • 2 Dept. of Internal Medicine, Fukui Prefectural Hospital, Fukui, Japan
Further Information

Publication History

Submitted 13 September 2002

Accepted after Revision 10 April 2003

Publication Date:
20 August 2003 (online)

Background and Study Aims: In difficult cases of selective bile duct cannulation, several expanded techniques are available which have only been partially evaluated in randomized studies. This study describes a prospective, randomized trial investigating a further technique for obtaining selective biliary access - pancreatic duct wire placement.
Patients and Methods: During a 6-month study period, 107 consecutive patients required deep selective biliary cannulation. Accessing the bile duct using a catheter failed within 10 min in 53 of the patients, who were randomly assigned to either preinsertion of a guide wire into the pancreatic duct or persistence with a conventional catheter. The success rate and complication rate were compared between these two groups.
Results: In the pancreatic duct guide-wire group (n = 27), the success rate was significantly higher than in the conventional group (93 % versus 58 %). No pancreatitis complications occurred in either group.
Conclusions: Inserting a guide wire into the pancreatic duct to facilitate deep selective bile duct cannulation is better than persisting with a conventional catheter. Further studies will be needed to confirm these results and to compare this method with other sophisticated techniques for obtaining selective access to the biliary duct.

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S. Maeda, M.D.

Dept. of Surgery, Fukui Prefectural Hospital

Yotsui 2-8-1 · Fukui-shi 910-8526 · Japan·


Fax: +81-776-548090

Email: pxt01173@nifty.ne.jp