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Proposed risk factors related to the development of post–endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis include procedure-induced traumatic injury to the papilla and hydrostatic pressure in the pancreas associated with contrast injection. Cannulation of the bile duct with the aid of a guide wire might be associated with lower risk for post-ERCP pancreatitis than conventional cannulation, which uses contrast injection. Now, researchers in Korea have performed a randomized, prospective trial to evaluate this possibility.
A total of 300 patients who received therapeutic biliary ERCP were randomized to wire-guided cannulation (WGC) using a hydrophilic guide wire preloaded through a sphincterotome or conventional cannulation u…