Belverde Barbara, Frattaroli Stefano, Carbone Antonella, Viceconte Giovanni
Department of Surgery Sciences, University of Rome, Rome, Italy.
Ann Ital Chir. 2012 Sep-Oct;83(5):391-3.
The aim of this study is to report our experience using double guide-wire technique (DGT) for biliary cannulation.
From 2007 to 2010, out of 1607 consecutive patients undergoing ERCP with the intent to cannulate the common bile duct (CBD) 1335 were considered suitable for this study. In 131 of these patients deep biliary cannulation with standard cannulation technique (SCT) failed. In these cases DGT was attempted.
DGT could be used in 121 patients with success rate of deep biliary cannulation in 117 (96.7%) with a 2.6% rate post ERCP pancreatitis.
Since difficulties in selective cannulation are sometimes encountered due to anatomical constraints or papillary spasm, pharmacologic aids and other non invasive methods such as papillotome cannulation or guidewire cannulation are used. DGT consented a high rate of successful selective biliary cannulation with a low rate of complications.
According to our experience we can concluded, that in expert hands, the double guidewire technique (DGT) can be considered useful and safe method in difficult biliary cannulation, reducing the need of more invasive technique such as precut papillotomy.
本研究旨在报告我们使用双导丝技术（DGT）进行胆管插管的经验。
2007年至2010年，在1607例连续接受内镜逆行胰胆管造影（ERCP）且意图对胆总管（CBD）进行插管的患者中，1335例被认为适合本研究。在这些患者中，131例采用标准插管技术（SCT）进行深部胆管插管失败。在这些情况下尝试了DGT。
DGT可用于121例患者，深部胆管插管成功率为117例（96.7%），ERCP术后胰腺炎发生率为2.6%。
由于有时会因解剖结构限制或乳头痉挛而在选择性插管时遇到困难，因此会使用药物辅助及其他非侵入性方法，如乳头切开刀插管或导丝插管。DGT实现了较高的选择性胆管插管成功率且并发症发生率较低。
根据我们的经验可以得出结论，在专家手中，双导丝技术（DGT）在困难胆管插管中可被视为一种有用且安全的方法，减少了对诸如预切开乳头括约肌切开术等更具侵入性技术的需求。
