新型 J 形尖端导丝：导丝引导下套管插管的初步可行性研究。
Newly designed J-shaped tip guidewire: a preliminary feasibility study in wire-guided cannulation.
机构信息
Division of Gastroenterology, Department of Internal Medicine, Toho University Ohashi Medical Center, Tokyo 153-8515, Japan.
出版信息
World J Gastroenterol. 2013 Jul 28;19(28):4531-6. doi: 10.3748/wjg.v19.i28.4531.
AIM
To perform wire-guided cannulation using a newly designed J-shaped tip guidewire, and to verify feasibility and safety for use.
METHODS
The study was conducted on endoscopic retrograde cholangiopancreatography (ERCP) patients with naïve papilla undergoing diagnosis and treatment of biliary diseases between September 2011 and July 2012. We performed ERCP in a succession of 50 cases with a J-shaped tip guidewire. The first insertion attempt began with a trainee who had 5 min to complete cannulation, followed if necessary by the trainer for another 5 min. We assessed the primary success rate of selective biliary cannulation within 10 min and adverse events such as post-ERCP pancreatitis (PEP), bleeding or perforation.
RESULTS
The primary success rate was 90% (45/50) within 10 min, the initial success rate within 5 min by trainee staff was 76% (38/50). The rate of PEP was 6% (3/50), but all 3 cases were mild pancreatitis. All patients were managed successfully with conservative treatment. There was no bleeding or perforation.
CONCLUSION
A newly designed J-shaped tip guide-wire has the possibility to facilitate selective biliary cannulation for ERCP and appears to be safe.
目的
使用新设计的 J 型尖端导丝进行经导丝引导的插管，并验证其使用的可行性和安全性。
方法
该研究于 2011 年 9 月至 2012 年 7 月期间，对接受诊断和治疗胆道疾病的初次乳头插管的内镜逆行胰胆管造影（ERCP）患者进行，使用 J 型尖端导丝进行了连续 50 例 ERCP。首次插管尝试由一名受训者进行，他有 5 分钟的时间完成插管，如果需要，再由培训师进行另外 5 分钟。我们评估了 10 分钟内选择性胆管插管的主要成功率和不良事件，如 ERCP 后胰腺炎（PEP）、出血或穿孔。
结果
10 分钟内主要成功率为 90%（45/50），受训者在 5 分钟内的初始成功率为 76%（38/50）。PEP 的发生率为 6%（3/50），但所有 3 例均为轻度胰腺炎。所有患者均经保守治疗成功处理，无出血或穿孔。
结论
新设计的 J 型尖端导丝有可能促进 ERCP 的选择性胆管插管，并且似乎是安全的。
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