Reply to Fuccio and Cennamo

Abstract

We thank Drs Fuccio and Cennamo for their interest in the cannulation paper. I agree that the recent data suggests that wire-guided cannulation (WGC) should now be the initial and preferred technique for conventional biliary cannulation. Two published meta-analyses, including the study by Cennamo and co-workers of the five randomized trials, confirm superior primary cannulation rates, decreased precut requirements and a significantly reduced risk of post-ERCP pancreatitis (PEP) [1] [2]. Thus, it seems that not only in theory, but also in practice, WGC for biliary cannulation is both safer and more effective.