{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T11:55:37Z","timestamp":1787313337080,"version":"build-2736575974"},"reference-count":26,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2013,8,12]],"date-time":"2013-08-12T00:00:00Z","timestamp":1376265600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Digestive Endoscopy"],"published-print":{"date-parts":[[2014,5]]},"abstract":"\n Background and Aim<\/jats:title>\n \n Although biliary cannulation with pancreatic guidewire placement (\n P<\/jats:styled-content>\n \u2010\n GW<\/jats:styled-content>\n ) is useful for difficult cases in endoscopic retrograde cholangiopancreatography (\n ERCP<\/jats:styled-content>\n ), the clinical significance of wire\u2010guided cannulation with\n P<\/jats:styled-content>\n \u2010\n GW<\/jats:styled-content>\n (double\u2010guidewire technique:\n DGT<\/jats:styled-content>\n ) has not been clarified. The aim of the present study was to evaluate the usefulness of\n DGT<\/jats:styled-content>\n for difficult biliary cannulation after unsuccessful biliary cannulation using a cannula\/sphincterotome under guidance of injected contrast with\n P<\/jats:styled-content>\n \u2010\n GW<\/jats:styled-content>\n (single\u2010guidewire technique:\n SGT<\/jats:styled-content>\n ).\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n One\u2010hundred and forty\u2010six patients with difficult biliary cannulation who underwent\n SGT<\/jats:styled-content>\n were included in this retrospective study.\n DGT<\/jats:styled-content>\n was carried out if\n SGT<\/jats:styled-content>\n was unsuccessful. Pancreatic duct (\n PD<\/jats:styled-content>\n ) stenting was attempted to prevent post\u2010\n ERCP<\/jats:styled-content>\n pancreatitis (\n PEP<\/jats:styled-content>\n ) in all patients. The success rate of cannulation and the risk factors for\n PEP<\/jats:styled-content>\n were investigated.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Biliary cannulation with\n SGT<\/jats:styled-content>\n was achieved in 70%.\n DGT<\/jats:styled-content>\n was carried out in 25 patients with unsuccessful\n SGT<\/jats:styled-content>\n , biliarycannulation being successful in 72%. Of the 13 patients who underwent precut sphincterotomy, biliary cannulation was achieved in 46%. The incidence of\n PEP<\/jats:styled-content>\n in patients who had undergone\n SGT<\/jats:styled-content>\n ,\n DGT<\/jats:styled-content>\n , and precut sphincterotomy was 8% (12: mild, 8; moderate, 3; severe, 1), 4% (mild, 1), and 0%, respectively.\n PD<\/jats:styled-content>\n stenting was successfully carried out in 86%. Multivariate analysis revealed unsuccessful\n PD<\/jats:styled-content>\n stenting to be the only risk factor for\n PEP<\/jats:styled-content>\n (\n OR<\/jats:styled-content>\n 8.3, 95%\n CI<\/jats:styled-content>\n 2.3\u201330).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n DGT<\/jats:styled-content>\n may replace\n SGT<\/jats:styled-content>\n or become the salvage procedure in cases of unsuccessful\n SGT<\/jats:styled-content>\n as a result of its high success rate with an acceptable incidence of\n PEP<\/jats:styled-content>\n . Failed pancreatic duct stenting in these techniques was frequently associated with\n PEP<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/den.12158","type":"journal-article","created":{"date-parts":[[2013,8,12]],"date-time":"2013-08-12T21:34:41Z","timestamp":1376343281000},"page":"442-449","source":"Crossref","is-referenced-by-count":43,"title":["Clinical usefulness of double\u2010guidewire technique for difficult biliary cannulation in endoscopic retrograde cholangiopancreatography"],"prefix":"10.1111","volume":"26","author":[{"given":"Kei","family":"Ito","sequence":"first","affiliation":[{"name":"Department of Gastroenterology Sendai City Medical Center Sendai Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Horaguchi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Sendai City Medical Center Sendai 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