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Related Concept Videos

Endoscopic Procedures V: ERCP01:26

Endoscopic Procedures V: ERCP

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Endoscopic Retrograde Cholangiopancreatography (ERCP) is a diagnostic procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions related to the bile ducts, pancreatic ducts, and gallbladder. This procedure is beneficial for identifying and addressing blockages, gallstones, strictures, and tumors within the biliary or pancreatic systems. ERCP is both diagnostic and therapeutic, offering the ability to visualize and treat identified problems in one session.
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Endoscopic Procedures I: Esophagogastroduodenoscopy01:29

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An Esophagogastroduodenoscopy (EGD) is a diagnostic procedure in which an endoscopist uses a flexible, lighted endoscope to visualize the upper gastrointestinal (GI) tract. The procedure includes visualizing the oropharynx, esophagus, stomach, and the first part of the small intestine, the duodenum.
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Endoscopic Studies I: Bronchoscopy and Thoracoscopy01:30

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Angled-tip vs. straight-tip guidewire in ERCP: a randomized, multicenter study.

Johanes Hausmann1,2, Foteini Lefa3, Natalie Filmann4

  • 1Department of Internal Medicine 1, Goethe-University Hospital, Frankfurt, Main, Germany.

Scandinavian Journal of Gastroenterology
|November 23, 2022
PubMed
Summary
This summary is machine-generated.

Angled tip guidewires improve endoscopic retrograde cholangiopancreatography (ERCP) success rates, especially for intrahepatic strictures. Guidewire flexibility did not impact outcomes in this study.

Keywords:
Endoscopic retrograde cholangiopancreatography (ERCP)bile ductendoscopyguidewirerandomized trialstenosis

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Area of Science:

  • Gastroenterology
  • Medical Devices
  • Interventional Endoscopy

Background:

  • Endoscopic retrograde cholangiopancreatography (ERCP) is a key intervention for biliopancreatic diseases.
  • Guidewires are critical components for successful ERCP procedures.

Purpose of the Study:

  • To compare the efficacy of hydrophilic guidewires with straight versus angled tips in ERCP.
  • To evaluate the impact of guidewire tip flexibility (normal vs. enhanced) on ERCP success rates and procedure duration.

Main Methods:

  • A randomized, multicenter, open-label study involving 453 patients requiring guidewire use during ERCP.
  • Patients were randomized to receive either a straight tip (ST) or angled tip (AT) hydrophilic guidewire, with stratification by indication.
  • Success rate and procedural duration were primary endpoints; cross-over was permitted.

Main Results:

  • Overall success was achieved in 86% of procedures with the initially allocated guidewire.
  • Angled tip guidewires demonstrated a significantly higher success rate (87.5%) compared to straight tip guidewires (79.9%) (p=0.049).
  • Success rates for intrahepatic strictures were markedly higher with angled tips (90.7%) versus straight tips (69.1%) (p=0.008).

Conclusions:

  • ERCP guidewires with an angled tip configuration are more successful than straight tip wires, particularly for intrahepatic strictures.
  • Guidewire tip flexibility (standard vs. enhanced) did not significantly influence success rates across all indications.