Newly designed J-shaped tip guidewire: A preliminary feasibility study in wire-guided cannulation

Figure 1 Newly designed J-shaped tip guidewire. The shape of the tip is a radius of 1 mm; 50 mm from the tip is the start of a hydrophilic coating.

Figure 2 Endoscopic and fluoroscopic images showing the technique with J-shaped tip guidewire. A: Assistant endoscopist extended approximately 5 mm of the guidewire tip and restored it to the original “J” configuration (stand-by position); B: Selective biliary cannulation was attempted under endoscopic control without fluoroscopy; C: The guidewire was moved in an in-and-out motion by an assisting endoscopist. Once the guidewire was advanced without resistance, fluoroscopy was used to confirm successful cannulation; D: Contrast medium was injected after confirmation of successful biliary cannulation.

Figure 3 An image via intra-duodenal biliary segments of J-shaped tip guidewire (A) and standard guidewire (B). A: Blunted J-shaped tip may facilitate passage through intra-duodenal segment (arrow); B: Normal guidewire tips may be become stuck in epithelial folds or flexion of intra-duodenal biliary segments (arrowheads).