Application Advantages of ERCP Guidewire in Difficult ERCP

ERCP guidewire is the lifeline of difficult ERCP surgeries and exerts important function as common equipment in endoscope. This research prompts that using ERCP guidewire flexibly can increase the success rate, reduce complication occurrence and shorten operation time.

1. The tip of the ERCP guidewire is elastic, tissue-friendly, and very smooth when wet

It can explore lacuna of bile duct or pancreatic duct, enter them, pass through blocking or narrow place, and lead accessory passing and increase the success rate.

Radiography is the basis of treatment success. During radiography, use ERCP guidewire to grope in target duct. Put duct on papilla opening and lead ERCP guidewire from 11 o'clock direction to enter bile duct.

During deep intubation, because front end of ERCP guidewire is smooth and soft, get into by technique such as gently twisting, heavily twisting, propelling properly, shaking, etc. Sometimes, the walking direction of ERCP guidewire can be changed by combining with equipment such as saccule, incision knife, radiography vessel, etc. and get into target bile duct.

During cooperation with other equipment, pay attention to adjusting the distance between ERCP guidewire and catheter, tension of knife steel wire and different insertion depth of saccule, let ERCP guidewire enter target bile duct directly, and let an extra length of ERCP guidewire in and make it rebound in the round fold and become a hook, and then get into target bile duct.

ERCP guidewire getting into target bile duct is the key for smooth operation and reaching expected effect of diagnosis and treatment. The ERCP guidewire group has higher success rate than regular group.

2. Use the ERCP guidewire to exchange various instruments, making the operation more accurate and safer

Using ERCP guidewire flexibly can reduce operation time. If during radiography, smart knife with ERCP guidewire is directly used, decision of cutting can be made after radiography.

If cutting is needed, insert ERCP guidewire into bile duct, incision knife will not easily roll out of ERCP bile duct stent, and operation time is saved. If therapy shall be conducted after cutting, insert ERCP guidewire again into bile duct or pancreatic duct and withdraw incision knife, and replace with corresponding equipment.

During operation process, remember that don't pull away ERCP guidewire. Sometimes ERCP guidewire cannot enter original pipeline after abjection. When tumor at hepatic portal vein needs double bracket or multiple brackets, use double ERCP guidewires. Using ERCP guidewire flexibly can improve working efficiency obviously.

3. The back of front end part-steel wire: increase force of insertion to make net and bracket into target position

Use rigidity of ERCP guidewire to change direction of duodenal papilla, so that radiography and cutting become more smoothly, and complications will be reduced.

When take out biliary stone in liver, let ERCP guidewire get into target bile duct, put lithotomy saccule or net along with ERCP guidewire, and remove the stone. Meanwhile, before placing bracket, the key for success is to put ERCP guidewire into target bile duct. Without ERCP guidewire rigidity, the work cannot be done.

4. Using the strength of the ERCP guidewire can enhance the insertion force, guiding the basket and bracket into the target position

The common reason for postoperative pancreatitis and hyperamylasemia is checked pancreatic drainage and overhigh inner pressure of pancreatic duct. Inject contrast agent too much too quickly, pancreatic duct is overfilling, causes inner high-pressure, hurts pipe epithelium, as well as toxic effect of acinus contrast agent and duodenal contents activating pancreatin lead to pancreatic duct damage and substantial damage, so that autodigestion starts.

Judge direction of bile duct and pancreatic duct according to the travelling direction of ERCP guidewire, which can reduce obviously internal high pressure caused by overfilling contrast agent and reduce damage on pipe epithelium and acinus caused by toxicity of contrast agent. Meanwhile, the tip of yellow zebra guidewire is extremely soft with hydrophile, which has little damage on pancreatic duct, so that the incidence of post-ERCP pancreatitis and hyperamylasemia reduces.

X-ray proof function of ERCP guidewire can reduce application of contrast agent and decrease occurrence of cholangitis and pancreatitis.