Pancreatic duct guidewire placement for biliary cannulation in a single-session therapeutic ERCP

Table 1 Patient characteristics and indications n (%)

Dermographics
Patient number	2332
Age (year, mean)	68.4
Gender (male/female)	1236/1096
Indications
Choledocholithiasis	1732 (74.3)
Malignant stricture	545 (23.4)
Bile leak after cholecystectomy	42 (1.8)
Primary sclerosing cholangitis	11 (0.5)

Table 2 Comparison between single-guidewire technique/double-guidewire technique, single-guidewire technique/pre-cut failed double-guidewire technique and single-guidewire technique/pre-cut first step methods in terms of patient outcome, the development of asymptomatic hyperamylasemia or post-endoscopic retrograde cholangiopancreatography pancreatitis n (%)

Variables	SGT	DGT	SGT	Pre-cut failed DGT	SGT	Pre-cut first step
Outcome (success)	2153 (92.3)	49 (43.8)	2153 (92.3)	46 (73.0)	2153(92.3)	54 (80.6)
P value1	< 0.001a		< 0.001a		0.002a
Asymptomatic hyperamylasemia	258 (12.0)	11 (22.4)	258 (12.0)	15 (23.8)	258 (12.0)	10 (14.9)
P value1	0.046a		0.008a		0.591
PEP	115 (5.3)	3 (6.1)	115 (5.3)	5 (7.9)	115 (5.3)	5 (7.5)
P value1	0.935		0.538		0.629

^aP < 0.05.

¹Calculated by Fisher’s exact test; SGT: Single-guidewire technique; DGT: Double-guidewire technique; PEP: Post-endoscopic retrograde cholangiopancreatography pancreatitis.

Table 3 Comparison between double-guidewire technique/pre-cut failed double-guidewire technique, pre-cut failed double-guidewire technique /pre-cut first step and double-guidewire technique/pre-cut first step methods in terms of patient outcome, the development of asymptomatic hyperamylasemia or post-endoscopic retrograde cholangiopancreatography pancreatitis n (%)

Variables	DGT	Pre-cut failed DGT	Pre-cut failed DGT	Pre-cut first step	DGT	Pre-cut first step
Outcome (success)	49 (43.8)	46 (73.0)	46 (73.0)	54 (80.6)	49 (43.8)	54 (80.6)
P value1	< 0.001a		0.405		< 0.001a
Asymptomatic hyperamylasemia	11 (22.4)	15 (23.8)	15 (23.8)	10 (14.9)	11 (22.4)	10 (14.9)
P value1	0.955		0.266		0.426
PEP	3 (6.1)	5 (7.9)	5 (7.9)	5 (7.5)	3 (6.1)	5 (7.5)
P value1	0.999		0.588		0.928

^aP < 0.05.

¹Calculated by Fisher’s exact test. SGT: Single-guidewire technique; DGT: Double-guidewire technique; PEP: Post-endoscopic retrograde cholangiopancreatography pancreatitis.

Table 4 Logistic regression analysis for every possible comparison of the cannulation method used, for the prediction of outcome (failure)

Method	HR1	95% CI	P value2
SGT	1
Pre-cut first step	1.43	1.16-1.76	0.001
SGT	1
DGT	3.93	3.21-4.81	< 0.001
Pre-cut first step	1
DGT	1.23	1.13-1.35	< 0.001
Pre-cut first step	1
Pre-cut failed DGT	1.063	0.95-1.20	0.307

¹Hazard ratio;

²Test for trend. SGT: Single-guidewire technique; DGT: Double-guidewire technique.

Table 5 Associations between the development of post-endoscopic retrograde cholangiopancreatography pancreatitis and the initial pathology within groups of patients who underwent each cannulation method n (%)

Method	Choledocholithiasis	Malignancy
Pre-cut first step
PEP	5 (19.2)	0 (0.0)
P value1	0.007a
DGT
PEP	3 (8.3)	0 (0.0)
P value1	0.556
Pre-cut failed DGT
PEP	5 (16.1)	0 (0.0)
P value1	< 0.001a
SGT
PEP	97 (5.8)	17 (3.9)
P value1	0.146

^aP < 0.05.

¹Calculated by Fisher’s exact test. SGT: Single-guidewire technique; DGT: Double-guidewire technique; PEP: Post-endoscopic retrograde cholangiopancreatography pancreatitis.

Table 6 Associations between patient gender and the presence of PEP and asymptomatic hyperamylasemia, within groups of patients who underwent each cannulation method n (%)

Method	PEP	Asymptomatic hyperamylasemia
Pre-cut first step
Male	2 (5.1)	3 (7.7)
Female	3 (10.7)	7 (25.0)
P value1	0.642	0.081
DGT
Male	1 (3)	6 (18.2)
Female	2 (12.5)	5 (31.3)
P value1	0.086	0.467
Pre-cut failed DGT
Male	1 (2.9)	9 (26.5)
Female	4 (13.8)	6 (20.7)
P value1	0.171	0.768
SGT
Male	62 (5.5)	115 (10.2)
Female	53 (5.2)	143 (14.0)
P value1	0.77	0.008a

^aP < 0.05.

¹Calculated by Fisher’s exact test. SGT: Single-guidewire technique; DGT: Double-guidewire technique.