‘Double guidewire in one catheter’ method for a difficult endoscopic retrograde cholangiopancreatography cannulation (with video)

Comparison between double‐guidewire technique and transpancreatic sphincterotomy technique for difficult biliary cannulation

“…Placement of prophylactic pancreatic stents may lower the incidence of PEP in high‐risk patients and alleviate the severity of this condition . The guidewire‐assisted cannulation technique increased the primary cannulation rate and reduced the risk of PEP, and therefore appeared to be the most appropriate first‐line cannulation technique . In most cases, standard biliary cannulation was the initial attempt to achieve deep cannulation; however, even the most experienced endoscopists occasionally failed to cannulate the CBD by this standard technique.…”

“…17 The guidewire-assisted cannulation technique increased the primary cannulation rate and reduced the risk of PEP, and therefore appeared to be the most appropriate first-line cannulation technique. [18][19][20] In most cases, standard biliary cannulation was the initial attempt to achieve deep cannulation; however, even the most experienced endoscopists occasionally failed to cannulate the CBD by this standard technique. The precut technique was the most commonly used approach for difficult biliary cannulation as it could be conducted conveniently during the initial ERCP procedure.…”