Guide-wire versus conventional contrast cannulation of the common bile duct for the prevention of post-ERCP pancreatitis in patients with choledocholithiasis.

Background: Inadvertent injection of a contrast agent into the pancreatic duct is an important contributor factor to post-ERCP pancreatitis.

Aim: To compare the incidence of post-ERCP pancreatitis and the success rate of biliary cannulation using guide-wire cannulation or the standard contrast injection technique.

Methods: A total of 128 patients with choledocholithiasis who underwent either guide-were cannulation (n=70) or contrast injection (n=58) were retrospectively reviewed. Outcome measurements were post-ERCP pancreatitis and rate of successful common bile duct (CBD) cannulation.

Results: Three patients (4.3%) in the guide-wire cannulation group and five patients (8.6%) in the contrast injection group had post-ERCP pancreatitis (p>0.05). Successful CBD cannulation was achieved in 91.4% with guide-wire cannulation and in 88% with conventional contrast cannulation (p>0.05).

Conclusion: Our study failed to show significant reduction in the rate of post-ERCP pancreatitis with the use of guide-wire, although there was a downward trend. The success rate of cannulation was comparable between the two techniques.