Which Guidewire Caliber Is Superior for ERCP?

For years, interventional endoscopists have debated which is the best guidewire caliber for use in endoscopic retrograde cholangiopancreatography (ERCP). Some argue that wider-caliber (and often stiffer) 0.035-inch wires are less suitable for techniques such as guidewire cannulation, whereas others argue that thinner-caliber 0.025-inch wires do not provide enough stiffness and are more likely to traumatize the ampulla during cannulation. Now, in a multicenter, randomized trial, researchers have compared these two wire gauges in terms of the rate of successful guidewire cannulation and incidence of post-ERCP pancreatitis among approximately 700 patients undergoing ERCP.

The rate of primary guidewire cannulation of the bile duct was similar wi…