Double-guidewire technique for difficult bile duct cannulation: a multicenter randomized, controlled trial

Advances in endoscopic retrograde cholangiopancreatography cannulation

“…No significant differences were observed in success rates, cannulation times or number of attempts. A higher rate of postERCP pancreatitis was seen in the pancreatic duct guide wire group although this was not statistically significant [38] . We recommend the use of the pancreatic guide wire technique in difficult cannulation cases as it is the most efficient and safe method in our experience.…”

“…The pancreatic duct guide wire group had more hyperamylasemia compared to the conventional group but no patients had abdominal pain [35] . A more recent randomized controlled trial compared the pancreatic duct guide wire technique and standard cannulation technique in 188 patients with difficult CBD cannulation [38] . No significant differences were observed in success rates, cannulation times or number of attempts.…”

Prevention of post-ERCP pancreatitis

“…The authors underlined that the dual GW system might be associated with a higher risk of PEP. However, the limitation of the study included the quantity and number of contrast injections into the pancreatic duct (22). In another randomized controlled trial with 107 patients, biliary cannulation could not be achieved in 10 minutes with SC in 53 patients.…”

Endoscopic retrograde cholangiopancreatography complications: Techniques to reduce risk and management strategies

“…11,29,31 In situations where biliary cannulation is difficult and repeated pancreatic cannulation occurs, some experts advocate a double guidewire technique (DGWT) to increase success. [39][40][41][42] There are, however, reports of increased PEP with DGWT 43,44 and the risk is considerably higher (20%-30%) when pancreatic stents are not placed for prophylaxis (see below). A Japanese multicenter study reported that the risk of PEP (11%-32%) with the DGWT was directly correlated with the number of inadvertent pancreatic duct guidewire cannulations (GWCs).…”