The impact of wire caliber on ERCP outcomes: a multicenter randomized controlled trial of 0.025-inch and 0.035-inch guidewires
| Autor: | Rungsun Rerknimitr, Evan G. Ong, Milan S. Bassan, Khean-Lee Goh, Dong Wan Seo, James Y.W. Lau, D. Nageshwar Reddy, Praka Sundaralingam, Scott B. Fanning, Michael J. Bourke, Jayaram Menon, Hsiu-Po Wang, Eng Kiong Teo |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Postoperative Hemorrhage law.invention Catheterization 03 medical and health sciences 0302 clinical medicine Postoperative Complications Randomized controlled trial law Multicenter trial medicine Humans Radiology Nuclear Medicine and imaging Single-Blind Method Adverse effect Cholangiopancreatography Endoscopic Retrograde Endoscopic retrograde cholangiopancreatography medicine.diagnostic_test Common bile duct business.industry fungi Gastroenterology Middle Aged medicine.disease Surgery Clinical trial medicine.anatomical_structure Pancreatitis 030220 oncology & carcinogenesis Sphincter of Oddi dysfunction 030211 gastroenterology & hepatology Female business |
| Zdroj: | Gastrointestinal endoscopy. 87(6) |
| ISSN: | 1097-6779 |
| Popis: | Background and Aims Wire-guided biliary cannulation has been demonstrated to improve cannulation rates and reduce post-ERCP pancreatitis (PEP), but the impact of wire caliber has not been studied. This study compares successful cannulation rates and ERCP adverse events by using a 0.025-inch and 0.035-inch guidewire. Methods A randomized, single blinded, prospective, multicenter trial at 9 high-volume tertiary-care referral centers in the Asia-Pacific region was performed. Patients with an intact papilla and conventional anatomy who did not have malignancy in the head of the pancreas or ampulla and were undergoing ERCP were recruited. ERCP was performed by using a standardized cannulation algorithm, and patients were randomized to either a 0.025-inch or 0.035-inch guidewire. The primary outcomes of the study were successful wire-guided cannulation and the incidence of PEP. Overall successful cannulation and ERCP adverse events also were studied. Results A total of 710 patients were enrolled in the study. The primary wire-guided biliary cannulation rate was similar in 0.025-inch and 0.035-inch wire groups (80.7% vs 80.3%; P = .90). The rate of PEP between the 0.025-inch and the 0.035-inch wire groups did not differ significantly (7.8% vs 9.3%; P = .51). No differences were noted in secondary outcomes. Conclusion Similar rates of successful cannulation and PEP were demonstrated in the use of 0.025-inch and 0.035-inch guidewires. (Clinical trial registration number: NCT01408264.) |
| Databáze: | OpenAIRE |
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