“Biopsy forceps fixation”: novel trick of the trade for duodenal guidewire unlooping

Abstract

Bile duct stenting remains the clinical mainstay for establishing biliary drainage in malignant or benign strictures with successful and stable deep guidewire passage as the sine qua non. Duodenal loop formation of an effectively inserted guidewire may occur occasionally and threatens the procedural success in day-to-day ERC practice, which may even be more troublesome after cumbersome guidewire passage in the first place. Attempts to rescue wire positioning often fail, since the wire is typically in a dead angle with a tendency to completely slip out of postion no matter how the scope or cannula is navigated. Here, I present an easy-to-implement novel approach for duodenal guidewire unlooping, dubbed the "biopsy-forceps-fixation technique".

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