Selective Biliary Cannulation Using Pancreatic Guide-Wire Placement: Further Evidence Needed to Support the Use of an Already Known Technique

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

“…The use of different definitions of difficult CBD cannulation might have contributed to the differences in the percentage of patients randomized (50% in the Maeda et al study vs 23% in our study). We used a limit of 5 cannulation Contrast injection in the PD 37 (41) 37 (38) Precut technique 20 (22) 25 (26) Pneumatic balloon dilation of the papilla 1 (1) 0…”

“…The superior rate of CBD cannulation when using DGT has been attributed to the capability of the pancreatic guidewire to straighten both the PD and CBD while at the same time occupying the PD, thus facilitating CBD cannulation and preventing repeated PD cannulation. [18][19][20] These promising results of DGT prompted us to design a multicenter randomized trial with a significant number of patients (addressing the limitations reported by some authors 25,26 ) to test the hypothesis that in patients with difficult CBD cannulation, DGT has a higher success rate and/or fewer attempts required to achieve it compared with standard cannulation technique (SCT). 11 …”