Brief Article
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World J Gastroenterol. Jul 28, 2013; 19(28): 4531-4536
Published online Jul 28, 2013. doi: 10.3748/wjg.v19.i28.4531
Newly designed J-shaped tip guidewire: A preliminary feasibility study in wire-guided cannulation
Shigefumi Omuta, Iruru Maetani, Hiroaki Shigoka, Katsushige Gon, Michihiro Saito, Junya Tokuhisa, Mieko Naruki
Shigefumi Omuta, Iruru Maetani, Hiroaki Shigoka, Katsushige Gon, Michihiro Saito, Junya Tokuhisa, Mieko Naruki, Division of Gastroenterology, Department of Internal Medicine, Toho University Ohashi Medical Center, Tokyo 153-8515, Japan
Author contributions: Omuta S contributed to analysis and interpretation of the data, drafting of the article and revising for reviewers comments; Maetani I contributed to conception and design, critical revision of the article and data collection; Shigoka H contributed to data collection; Omuta S, Gon K, Saito M, Tokuhisa J and Naruki M contributed to treatment of patients and data collection; all authors approved the final version of the paper.
Supported by Toho University Ohashi Medical Center
Correspondence to: Iruru Maetani, MD, Division of Gastroenterology, Department of Internal Medicine, Toho University Ohashi Medical Center, 2-17-6 Ohashi, Meguro-ku, Tokyo 153-8515, Japan. mtnir50637@med.toho-u.ac.jp
Telephone: +81-3-34681251 Fax: +81-3-54650210
Received: January 10, 2013
Revised: April 24, 2013
Accepted: May 9, 2013
Published online: July 28, 2013
Abstract

AIM: To perform wire-guided cannulation using a newly designed J-shaped tip guidewire, and to verify feasibility and safety for use.

METHODS: The study was conducted on endoscopic retrograde cholangiopancreatography (ERCP) patients with naïve papilla undergoing diagnosis and treatment of biliary diseases between September 2011 and July 2012. We performed ERCP in a succession of 50 cases with a J-shaped tip guidewire. The first insertion attempt began with a trainee who had 5 min to complete cannulation, followed if necessary by the trainer for another 5 min. We assessed the primary success rate of selective biliary cannulation within 10 min and adverse events such as post-ERCP pancreatitis (PEP), bleeding or perforation.

RESULTS: The primary success rate was 90% (45/50) within 10 min, the initial success rate within 5 min by trainee staff was 76% (38/50). The rate of PEP was 6% (3/50), but all 3 cases were mild pancreatitis. All patients were managed successfully with conservative treatment. There was no bleeding or perforation.

CONCLUSION: A newly designed J-shaped tip guide-wire has the possibility to facilitate selective biliary cannulation for ERCP and appears to be safe.

Keywords: J-shaped tip guidewire, Wire-guided cannulation, Endoscopic retrograde cholangiopancreatography, Biliary tract, Cannulation technique, Perforation

Core tip: We conducted a feasibility study that performed endoscopic retrograde cholangiopancreatography (ERCP) with a newly designed J-shaped tip guidewire. This new guidewire has a strongly-flexed atraumatic tip with hydrophilic coating; therefore, it may contribute to the improvement of the passage through the intra-duodenal biliary segment and to the decrease of adverse events such as post-ERCP pancreatitis. We assessed the primary success rate of selective biliary cannulation within 10 min and rate of post-ERCP pancreatitis. The primary success rate was 90% (45/50); the rate of post-ERCP pancreatitis was 6% (3/50), but all 3 cases were mild. The J-shaped tip guidewire may facilitate selective biliary cannulation in ERCP.