Tsuchiya Takayoshi, Itoi Takao, Maetani Iruru, Shigoka Hiroaki, Ikeuchi Nobuhito, Umeda Junko, Sofuni Atsushi, Itokawa Fumihide, Ishii Kentaro, Kurihara Toshio, Tsuji Shujiro, Tanaka Reina, Tonozuka Ryosuke, Honjyo Mitsuyoshi, Mukai Shuntaro, Moriyasu Fuminori
Department of Gastroenterology and Hepatology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan,
Dig Dis Sci. 2015 Aug;60(8):2502-8. doi: 10.1007/s10620-015-3658-0. Epub 2015 Apr 23.
Wire-guided cannulation has become a common biliary cannulation technique worldwide. Different guidewires with various tip shapes and materials have been reportedly used for wire-guided cannulation. However, there are apparently no studies reporting changes in the biliary cannulation rate according to the type of guidewire used.
We evaluated the effectiveness of the J-tip guidewire for biliary cannulation.
We conducted a prospective, multicenter, controlled study involving patients with a native papilla who required biliary cannulation. We allocated the patients to the J-tip guidewire or angled-tip guidewire groups (groups J and A, respectively). If biliary cannulation was not achieved within 10 min, the GW was changed and cannulation was continued.
Groups J and A consisted of 66 and 65 enrolled patients, respectively. The biliary cannulation rate with a single guidewire for the first 10 min was 84.8 % (56/66) for group J and 80.0 % (52/65) for group A. The final success rate for biliary cannulation was 100 % in both groups. The mean times necessary for biliary cannulation were 285.8 and 267.6 s in group J and group A, respectively. The incidence rates of complications (i.e., all mild pancreatitis) were 3.0 % (2/66) and 6.2 % (4/65) in group J and group A, respectively. The mean amylase concentrations were 168.0 and 297.7 IU/L in group J and group A, respectively. There were no significant differences in any results between both groups.
The biliary cannulation rate of the J-tip guidewire was not significantly different from those of standard guidewires.
导丝引导下的插管术已成为全球常见的胆管插管技术。据报道,不同形状尖端和材料的导丝已用于导丝引导下的插管术。然而,显然尚无研究报告根据所用导丝类型胆管插管率的变化情况。
我们评估了J形尖端导丝用于胆管插管的有效性。
我们进行了一项前瞻性、多中心、对照研究,纳入需要胆管插管的天然乳头患者。我们将患者分为J形尖端导丝组或斜角尖端导丝组(分别为J组和A组)。如果在10分钟内未完成胆管插管,则更换导丝并继续插管。
J组和A组分别纳入66例和65例患者。J组在前10分钟使用单一导丝的胆管插管率为84.8%(56/66),A组为80.0%(52/65)。两组胆管插管的最终成功率均为100%。J组和A组胆管插管所需的平均时间分别为285.8秒和267.6秒。J组和A组并发症(即均为轻度胰腺炎)的发生率分别为3.0%(2/66)和6.2%(4/65)。J组和A组的平均淀粉酶浓度分别为168.0 IU/L和297.7 IU/L。两组之间的任何结果均无显著差异。
J形尖端导丝的胆管插管率与标准导丝的胆管插管率无显著差异。