Angled tip ERCP Guidewires Appear To Be Advantageous for Intrahepatic Stenosis in Comparison to Straight tip Guidewires: Results from a Randomized Multicentre Study

Aims Endoscopic retrograde cholangiopancreatography (ERCP) is the mainstay for treating many bilio-pancreatic diseases and highly effective guidewires are essential for treatment success. However, performance of different types of guidewires remains ambiguous in most indications.

Methods We conducted a randomized, multicentre, open label study involving four European endoscopic centres. Success rate and duration of ERCP were evaluated in terms of the respective guidewire system. Two wire types were compared, each with either a straight tip or an angled tip configuration, thereby resulting in four randomization groups: Type 1 wire, providing a hydrophilic tip with normal flexibility, and type 2, with enhanced tip flexibility. Patients were stratified by indication (i.e., stenosis of the intra- or extrahepatic bile ducts, bile duct stones, or interventions involving the pancreas). Cross-over of groups was conducted if passage of the stenosis or stone was not achieved with the initially allocated wire.

Results Four hundred fifty-four patients were included. In 363 procedures (80 %), the use of the initially allocated wire resulted in treatment success. Success rate was higher for using wires with an angled tip in treating intrahepatic stenoses (p = 0.009). No significant differences were observed in other indications. Furthermore, success was equal in applying wire type 1 vs. type 2. No differences were observed between the four groups in terms of procedure time.

Conclusions ERCP guidewires with an angled tip were more frequently successful in treating intrahepatic stenosis when compared to straight tipped wires. Guidewires with normal vs. enhanced tip flexibility showed equal success rates for the respective indications.

Citation: Garcés-Duran R, Galdin-Ferreyra M, Delgado-Guillena P et al. OP135 ANGLED TIP ERCP GUIDEWIRES APPEAR TO BE ADVANTAGEOUS FOR INTRAHEPATIC STENOSIS IN COMPARISON TO STRAIGHT TIP GUIDEWIRES: RESULTS FROM A RANDOMIZED MULTICENTRE STUDY. Endoscopy 2021; 53: S56.

Publication History

Article published online:
19 March 2021