Loop-tipped Guidewire in Selective Biliary Cannulation

Background Advanced guidewires with a U-shaped tip could effectively cross the long or multi-occlusive segment smoothly and go into the distal outflow vessel. The guidewire looping technique is a safe and effective method for the recanalization of the occluded lesions in infrapopliteal vessels. Objective - To compare the performance a loop-tipped guidewire with a straight-tipped guidewire in achieving successful deep biliary cannulation. Design - Prospective randomized trial. Setting: - Tertiary-care medical center Patients - This study will involve 192 patients with biliary diseases which require endoscopic retrograde cholangiopancreatography. Intervention - Cannulation of bile duct by using a loop-tipped guidewire or a straight-tipped guidewire Main outcome measurements - Compare the cannulation success rate, the duration of the cannulation, immediate and late complications.

This study has two arms. We will compare the performance of a loop-tipped guidewire with a straight-tipped guidewire in achieving successful deep biliary cannulation with loop guidewire.

This study has two arms. We will compare the performance of a loop-tipped guidewire with a straight-tipped guidewire in achieving successful deep biliary cannulation with straight guidewire.

Up to 9 months, The primary outcome measure will be assessed after the enrollment of patients (anticipated time: 2014/08/30).

Up to 9 months, The secondary outcome measure will be assessed after the enrollment of patients (anticipated time: 2014/08/30).

Inclusion Criteria: age > 19 and ability to consent no evidence of significant cardiopulmonary or medical comorbidities precluding participation Exclusion Criteria: Known gastroduodenal anatomic abnormalities Coagulation disorders (international normalized ratio > 1.5 or platelet count < 50000 cells/cubic millimeter) Prior gastric surgery,endoscopic retrograde cholangiopancreatography Pregnancy