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CC BY-NC-ND 4.0 · Endosc Int Open 2022; 10(07): E990-E997
DOI: 10.1055/a-1834-7101
Original article

Impact of guidewire caliber on ERCP outcomes: Systematic review and meta-analysis comparing 0.025- and 0.035-inch guidewires

Muhammad Aziz‡
1   Division of Gastroenterology and Hepatology, University of Toledo, Toledo, Ohio, United States
,
Amna Iqbal‡
2   Department of Internal Medicine, University of Toledo, Toledo, Ohio, United States
,
Zohaib Ahmed
2   Department of Internal Medicine, University of Toledo, Toledo, Ohio, United States
,
Saad Saleem
3   Department of Internal Medicine, Sunrise Hospital and Medical center, Las Vegas, Nevada, United States
,
Wade Lee-Smith
4   University of Toledo Libraries, University of Toledo, Toledo, Ohio, United States
,
Hemant Goyal
5   The Wright Center for Graduate Medical Education, Scranton, Pennsylvania, United States
,
Faisal Kamal
6   Division of Gastroenterology, University of California San Francisco, San Francisco, California, United States
,
Yaseen Alastal
1   Division of Gastroenterology and Hepatology, University of Toledo, Toledo, Ohio, United States
,
Ali Nawras
1   Division of Gastroenterology and Hepatology, University of Toledo, Toledo, Ohio, United States
,
Douglas G. Adler
7   Center for Advanced Therapeutic Endoscopy (CATE), Porter Adventist Hospital/PEAK Gastroenterology, Denver, Colorado, United States
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Abstract

Background and study aims The impact of guidewire caliber on endoscopic retrograde pancreatography (ERCP) outcomes are not clear. Recent studies have compared two guidewires, 0.035- and 0.025-inch, in randomized controlled trials (RCTs). We performed a systematic review and meta-analysis of available RCTs to assess if different caliber would change the outcomes in ERCP.

Patients and methods A systematic search of PubMed/Medline, Embase, Cochrane, SciELO, Global Index Medicus and Web of Science was undertaken through November 23, 2021 to identify relevant RCTs comparing the two guidewires. Binary variables were compared using random effects model and DerSimonian-Laird approach. For each outcome, risk-ratio (RR), 95 % confidence interval (CI), and P values were generated. P < 0.05 was considered significant.

Results Three RCTs with 1079 patients (556 in the 0.035-inch group and 523 in the 0.025-inch group) were included. The primary biliary cannulation was similar in both groups (RR: 1.02, CI: 0.96–1.08, P = 0.60). The overall rates of PEP were also similar between the two groups (RR: 1.15, CI: 0.73–1.81, P = 0.56). Other outcomes (overall cannulation rate, cholangitis, perforation, bleeding, use of adjunct techniques) were also comparable.

Conclusions The results of our analysis did not demonstrate a clear benefit of using one guidewire over other. The endoscopist should consider using the guidewire based on his technical skills and convenience.

Supplementary material



Publication History

Received: 20 February 2022

Accepted after revision: 25 April 2022

Accepted Manuscript online:
25 April 2022

Article published online:
15 July 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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