A new guidewire cannulation technique in ERCP: successful deep biliary access with triple-lumen sphincterotome and guidewire controlled by the endoscopist

López, Alexis A.; Ferrer, Isabel; Villagrasa, Rosa Ana; Ortiz, Inmaculada; Maroto, Nuria; Montón, Cristina; Hinojosa, Joaquín; Moreno-Osset, E

doi:10.1007/s00464-010-1479-y

Cited by 6 publications

(4 citation statements)

References 34 publications

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“…Often this is not possible and in almost all of our series, the same physician had to deal with both aspects. Non-fluoroscopic techniques are facilitated by the use of guidewires to cannulate the papilla of Vater and the employ of rapid exchange devices that allow the endoscopist to control the guide in case there are not trained endoscopist assistants (25).…”

Section: Discussionmentioning

confidence: 99%

ERCP during pregnancy

García-Cano¹,

Pérez-Miranda

Roldán

et al. 2012

Rev. esp. enferm. dig.

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Background and aims: ERCP during pregnancy is always challenging for the entire team performing the endoscopic intervention. In this study techniques and different interventional aspects used at several centres about the clinical experience on ERCP in pregnant women are analyzed.Patients and methods: the practice on ERCP in pregnant women in six centres during a period of ten years is reported.Results: eleven patients were included in the study. Mean age was 30.6 years. Indication for ERCP was always symptomatic common bile duct stone (CBDS) disease. Before the procedure abdominal ultrasound was performed at all times and magnetic resonance cholangiopancreatography in four occasions. Conscious sedation by means of midazolam and fentanyl or meperidine was applied. Sphincterotomes and guidewires were used for bilary cannulation. Sometimes, rapid exchange platforms with short-length guidewires controlled by the same endoscopist were employed. Biliary cannulation was confirmed in 9 occasions by bile aspiration. In five procedures, a mean of 30 seconds of fluoroscopy was used, both to verify cannulation and to corroborate complete CBDS clearance. These patients had the pelvic zone protected with a lead shield and radiation dose was measured. Ten biliary sphincterotomies were performed followed by CBDS extraction. Two plastic stents were inserted. Relief of biliary obstruction was attained in all circumstances. Only one patient had hyperamylasemia after ERCP. All pregnant women had healthy foetuses with normal deliveries.Conclusions: with experience, ERCP appears to be a safe technique during pregnancy. With simple measures fluoroscopic time can be diminished or even abolished. It seems that ERCP during pregnancy is underused in our working areas, although it has shown to be a useful technique for relieving biliary obstruction

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Section: Discussionmentioning

confidence: 99%

ERCP during pregnancy

García-Cano¹,

Pérez-Miranda

Roldán

et al. 2012

Rev. esp. enferm. dig.

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“…5 Favorable results can also be observed when an assistant endoscopist controls the guidewire, even when there has been little prior experience with GWC. Successful bile duct access using endoscopist-controlled GWC is independent of assistant experience and case volume of the center.…”

Section: Guidewire Cannulation: Friend or Foementioning

confidence: 99%

“…[2][3][4][5][6][7] Therefore, the results of those single-center RCTs cannot be generalized to every endoscopist. He suggests that the preferred technique for wireguided cannulation (WGC) is an endoscopist (physician)controlled WGC, but this technique depends on the expertise of the endoscopist.…”

Section: Responsementioning

confidence: 99%

Guidewire cannulation: friend or foe

Tarnasky

2012

Gastrointestinal Endoscopy

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“…The widespread adoption of sphincterotomes over straight cannulas, wire-guided cannulation, physiciancontrolled guidewires, the use of rectal nonsteroidal antiinflammatory drugs, and other techniques are just a few of these bedrock techniques. [1][2][3][4][5] To date, only limited research has been focused on the effect of the ampulla itself on biliary cannulation outcomes. 6,7 This may, in part, be because the native or naïve papilla (defined as a major papilla that has not undergone a prior biliary sphincterotomy) has such a variable appearance and because a uniform and universally accepted language to describe the papilla itself does not exist.…”

mentioning

confidence: 99%