The effectiveness of a novel highly flexible-tip guidewire on selective biliary cannulation compared to conventional guidewire: a randomized controlled study

Abstract

Background/aim

Endoscopic access to the common bile duct remains difficult in 10% of cases undergoing endoscopic retrograde cholangiopancreaticography (ERCP). In the current study, we evaluated the effectiveness of a stiff-shaft and flexible-tip guidewire (Visiglide2^®) for selective biliary access.

Methods

We conducted a prospective, randomized controlled study involving patients with a naïve papilla who required biliary cannulation in a single center. We randomly allocated the patients to the Visiglide 2 group (Group V) or conventional guidewire group (Group C). The primary success rate of biliary cannulation, cannulation time, number of papillary attempts, number of pancreatic duct cannulations, total procedure time and final success rate were recorded during the endoscopic procedure.

Results

A total of 100 patients were enrolled and assigned to group V (n=50) and C (n=50) in the current study. The primary selective biliary cannulation of group V tends to show a higher success rate than that of group C (group V, 96% (48/50); group C, 86% (43/50); P=0.08). The final success rate for biliary cannulation was 100% in both groups. The mean times for biliary cannulation were 174.9 sec for group V and 363.5 sec for group C (P=0.04). The number of papillary attempts for cannulation was significantly fewer in group V (1.84) than those of group C (3.44; P<0.01).

Conclusion

The use of Visiglide 2 guidewire might facilitate the selective biliary cannulation compared to conventional guidewire in terms of reducing cannulation time and papilla attempts.

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