A prospective randomized controlled study of selective common bile duct cannulation guided by loach guide wire and zebra guide wire in ERCP

Abstract

Objective To compare curve-tip angiography guide wire （loach guide wire） and ultrasmooth hydrophilic guide wire （ zebra guide wire） in selective common bile duct （CBD） cannulation of endoscopic retrograde cholangiopanereatography （ERCP）. Methods A total of 196 patients were randomly assigned to loach guide wire group to receive cannulation guided by loach guide wire first （ n = 98 ） and zebra guide wire group to use zebra guide wire first （n = 98 ）. If cannulation was not successful after 10 minutes, a further attempt was made for an additional 10 minutes using the alternative guide wire. If still not successful after 10 minutes, other cannulation accessories would be used. The primary and overall selective cannulation time, success rate, and post-procedure abdominal pain and serum amylase were assessed. Results The primary success rate of selective CBD cannulation was higher in the loach guide wire group （93.9%） than that in zebra guide wire group （86. 7%, P 〈0. 05）, while there was no significant difference in cannulation time between 2 groups （ P 〉 0. 05 ）. The cannulation success rate after crossover was higher in loach guide wire group （76.9%） than that in zebra guide wire group （0. 0% , P 〈0. 05）. There was no significant difference in post-procedure serum amylase or occurrence rate of post ERCP pancreatitis between 2 groups （ P 〉 0. 05 ）. Conclusion Loach guide wire is superior to zebra guide wire in ERCP selective CBD cannulation, which can replace zebra guide wire in difficult cannulation. Key words: Cholangiopanereatography, endoscopic retrograde ; Loach guide wire ; Zebra guide wire