Background and Study Aims: In difficult cases of selective bile duct cannulation, several expanded techniques are available which have only been partially evaluated in randomized studies. This study describes a prospective, randomized trial investigating a further technique for obtaining selective biliary access - pancreatic duct wire placement.
Patients and Methods: During a 6-month study period, 107 consecutive patients required deep selective biliary cannulation. Accessing the bile duct using a catheter failed within 10 min in 53 of the patients, who were randomly assigned to either preinsertion of a guide wire into the pancreatic duct or persistence with a conventional catheter. The success rate and complication rate were compared between these two groups.
Results: In the pancreatic duct guide-wire group (n = 27), the success rate was significantly higher than in the conventional group (93 % versus 58 %). No pancreatitis complications occurred in either group.
Conclusions: Inserting a guide wire into the pancreatic duct to facilitate deep selective bile duct cannulation is better than persisting with a conventional catheter. Further studies will be needed to confirm these results and to compare this method with other sophisticated techniques for obtaining selective access to the biliary duct.
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S. Maeda, M.D.
Dept. of Surgery, Fukui Prefectural Hospital
Yotsui 2-8-1 · Fukui-shi 910-8526 · Japan·
Fax: +81-776-548090
eMail: pxt01173@nifty.ne.jp
