{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T10:07:11Z","timestamp":1781777231661,"version":"3.54.5"},"reference-count":23,"publisher":"Georg Thieme Verlag KG","issue":"11","license":[{"start":{"date-parts":[[2021,11,12]],"date-time":"2021-11-12T00:00:00Z","timestamp":1636675200000},"content-version":"vor","delay-in-days":11,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endosc Int Open"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background and study aims\u2002Approximately 11\u200a% of biliary cannulations are considered difficult. The double guidewire (DGW-T) and transpancreatic sphincterotomy (TPS) are two useful techniques when difficult cannulation exists and the main pancreatic duct is unintentionally accessed. We carried out a systematic review and meta-analysis to evaluate the effectiveness and security of both DGW-T and TPS techniques in difficult biliary cannulation.<\/jats:p><jats:p>\n          Methods\u2002We conducted a systematic review in different databases, such as PubMed, OVID, Medline, and Cochrane Databases. Were included all RCT which showed a comparison between TPS and DGW in difficult biliary cannulation. Endpoints computed were successful cannulation rate, median cannulation time, and adverse events rate.<\/jats:p><jats:p>\n          Results\u2002Four studies were selected (4 RCTs). These studies included 260 patients. The mean age was 64.79\u200a\u00b1\u200a12.99 years. Of the patients, 53.6\u200a% were men and 46.4\u200a% were women. The rate of successful cannulation was 93.3\u200a% in the TPS group and 79.4\u200a% in the DGW-T group (P\u200a=\u200a0.420). The rate of post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP) was lower in patients who had undergone TPS than DGW-T (TPS: 8.9\u200a% vs DGW-T: 22.2\u200a%, P\u200a=\u200a0.02). The mean cannulation time was 14.7\u200a\u00b1\u200a9.4\u200amin in the TPS group and 15.1\u200a\u00b1\u200a7.4\u200amin with DGW-T (P\u200a=\u200a0.349).<\/jats:p><jats:p>\n          Conclusions\u2002TPS and DGW are two useful techniques in patients with difficult cannulation. They both have a high rate of successful cannulation; however, the PEP was higher with DGW-T than with TPS.<\/jats:p>","DOI":"10.1055\/a-1534-2388","type":"journal-article","created":{"date-parts":[[2021,11,12]],"date-time":"2021-11-12T23:51:01Z","timestamp":1636761061000},"page":"E1758-E1767","source":"Crossref","is-referenced-by-count":12,"title":["Transpancreatic precut papillotomy versus double-guidewire technique in difficult biliary cannulation: a systematic review and meta-analysis"],"prefix":"10.1055","volume":"09","author":[{"given":"Edson","family":"Guzm\u00e1n-Calder\u00f3n","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit of Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru"},{"name":"Universidad Peruana de Ciencias Aplicadas (UPC)"},{"name":"Gastroenterology Unit of Angloamericana Clinic \u2013 Lima, Per\u00fa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Belen","family":"Martinez-Moreno","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit of Hospital General Universitario de Alicante, Alicante, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan A.","family":"Casellas","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit of Hospital General Universitario de Alicante, Alicante, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Ram\u00f3n","family":"Aparicio","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit of Hospital General Universitario de Alicante, Alicante, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2021,11,12]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"1696","DOI":"10.1038\/ajg.2013.217","article-title":"Intraprocedural quality in endoscopic retrograde cholangiopancreatography: a meta-analysis","volume":"108","author":"A DeBenedet","year":"2013","journal-title":"Am J Gastroenterol"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1055\/s-0042-108641","article-title":"Papillary cannulation and sphincterotomy techniques at ERCP: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline","volume":"48","author":"P Testoni","year":"2016","journal-title":"Endoscopy"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1016\/j.gie.2016.09.037","article-title":"International consensus recommendations for difficult biliary access","volume":"85","author":"W Liao","year":"2017","journal-title":"Gastrointest Endosc"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/j.gie.2016.06.051","article-title":"ASGE Standards of Practice Committee. Adverse events associated with ERCP","volume":"85","author":"V Chandrasekhara","year":"2017","journal-title":"Gastrointest Endosc"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1016\/j.gie.2009.10.049","article-title":"Double-guidewire technique for difficult bile duct cannulation: why not insert a prophylactic pancreatic stent?","volume":"72","author":"T Nguyen-Tang","year":"2010","journal-title":"Gastrointest Endosc"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"S80","DOI":"10.1055\/s-2007-1001379","article-title":"A new method of achieving deep cannulation of the common bile duct during endoscopic retrograde cholangiopancreatography","volume":"30","author":"J Dumonceau","year":"1998","journal-title":"Endoscopy"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"700","DOI":"10.1016\/j.gie.2009.03.031","article-title":"Double-guidewire technique for difficult bile duct cannulation: a multicenter randomized controlled trial","volume":"70","author":"A Herreros de Tejada","year":"2009","journal-title":"Gastrointest Endosc"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1055\/s-0034-1391228","article-title":"Early use of double-guidewire technique to facilitate selective bile duct cannulation: the multicenter randomized controlled EDUCATION trial","volume":"47","author":"N Sasahira","year":"2015","journal-title":"Endoscopy"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1016\/S0016-5107(05)80011-2","article-title":"Common bile duct pre-cut sphincterotomy: transpancreatic sphincter approach","volume":"41","author":"J S Goff","year":"1995","journal-title":"Gastrointest Endosc"},{"key":"ref10","first-page":"698","article-title":"Pancreatic duct guidewire-indwelling method for patients resistant to selective biliary cannulation and usefulness of pre-cut papillotomy following unsuccessful biliary cannulation with pancreatic duct guidewire-indwelling method","volume":"58","author":"Y Sakai","year":"2011","journal-title":"Hepatogastroenterology"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1097\/MPA.0b013e31815ac54c","article-title":"Transpancreatic precut sphincterotomy for cannulation of inaccessible common bile duct: a safe and successful technique","volume":"36","author":"A Weber","year":"2008","journal-title":"Pancreas"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1016\/0140-6736(91)90201-Y","article-title":"Publication bias in clinical research","volume":"337","author":"P J Easterbrook","year":"1991","journal-title":"Lancet"},{"key":"ref13","first-page":"719","article-title":"Statistical aspects of the analysis of datafrom retrospective studies of disease","volume":"22","author":"N Mantel","year":"1959","journal-title":"J Natl Cancer Inst"},{"key":"ref14","first-page":"AB141","article-title":"DGT vs TPS in patients with initial pd cannulation by chance; prospective randomized multi-center study","volume":"75","author":"S Cha","year":"2012","journal-title":"Gastrointest Endosc"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"108","DOI":"10.3748\/wjg.v19.i1.108","article-title":"Double guidewire technique vs transpancreatic precut sphincterotomy in difficult biliary cannulation","volume":"19","author":"Y W Yoo","year":"2013","journal-title":"World J Gastroenterol"},{"key":"ref16","first-page":"33","article-title":"Transpancreatic precut papillotomy versus double-guidewire technique in difficult biliary cannulation: prospective randomized study","volume":"50","author":"H Sugiyama","year":"2018","journal-title":"Endoscopy"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"764","DOI":"10.21608\/ejhm.2019.24167","article-title":"Double guidewire technique versus transpancreatic sphincterotomy for difficult biliary cannulation","volume":"74","author":"E Mohie","year":"2019","journal-title":"Egyptian J Hosp Med"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1111\/den.12387","article-title":"Comparison between double-guidewire technique and transpancreatic sphincterotomy technique for difficult biliary cannulation","volume":"27","author":"L Huang","year":"2015","journal-title":"Dig Endosc"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"721","DOI":"10.1055\/s-2003-41576","article-title":"Prospective randomized pilot trial of selective biliary cannulation using pancreatic guidewire placement","volume":"35","author":"S Maeda","year":"2003","journal-title":"Endoscopy"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"700","DOI":"10.1016\/j.gie.2009.03.031","article-title":"Double guidewire technique for difficult bile duct cannulation: a multicenter randomized, controlled trial","volume":"70","author":"A Herreros de Tejada","year":"2009","journal-title":"Gastrointest Endosc"},{"key":"ref21","first-page":"235","article-title":"Efficacy and complications of double guidewire technique in biliary tract cannulation","volume":"37","author":"E Guzm\u00e1n-Calder\u00f3n","year":"2017","journal-title":"Rev Gastroenterol Peru"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1055\/s-2004-814315","article-title":"Pancreatic sphincter precutting to gain selective access to the common bile duct: a series of 172 patients","volume":"36","author":"R Akashi","year":"2004","journal-title":"Endoscopy"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1016\/S1542-3565(04)00484-7","article-title":"Prospective evaluation of pancreatic sphincterotomy as a precut technique for biliary cannulation","volume":"2","author":"M Kahaleh","year":"2004","journal-title":"Clin Gastroenterol Hepatol"}],"container-title":["Endoscopy International Open"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-1534-2388.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,11,12]],"date-time":"2021-11-12T23:54:21Z","timestamp":1636761261000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-1534-2388"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11]]},"references-count":23,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2021,10,25]]},"published-print":{"date-parts":[[2021,11]]}},"URL":"https:\/\/doi.org\/10.1055\/a-1534-2388","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2364-3722","2196-9736"],"issn-type":[{"value":"2364-3722","type":"print"},{"value":"2196-9736","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11]]}}}