Guidewire-Assisted Cannulation of the Bile Duct

Compared with the conventional contrast-assisted cannulation technique, guidewire-assisted cannulation was associated with lower rates of post-ERCP pancreatitis.

One of the most common major complications of endoscopic retrograde cholangiopancreatography (ERCP) is post-ERCP pancreatitis (PEP). Several randomized trials have assessed whether guidewire (GW)-assisted or conventional contrast (CC)-assisted bile duct cannulation is more effective in terms of preventing PEP, but the results were conflicting.

To resolve this issue, investigators performed a systematic review and a meta-analysis of randomized trials conducted through November 2008. From 2132 citations, seven randomized, controlled trials were analyzed (5 noncrossover trials involving 1138 patients, 2 crossover trials involving 745 patients; 5 full-text trials, 2 abstracts). In the full-text trials, the indications for ERCP included common bi…

Reviewing Author

Stuart Sherman, MD