{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T20:41:00Z","timestamp":1792701660410,"version":"4.5.0"},"reference-count":28,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T00:00:00Z","timestamp":1759968000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000780","name":"European Union","doi-asserted-by":"crossref","award":["GINOP-2.3.2-15-2016-00048 STAY ALIVE"],"award-info":[{"award-number":["GINOP-2.3.2-15-2016-00048 STAY ALIVE"]}],"id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100000780","name":"European Union","doi-asserted-by":"crossref","award":["EFOP-3.6.2-16-2017-0006 LIVE LONGER"],"award-info":[{"award-number":["EFOP-3.6.2-16-2017-0006 LIVE LONGER"]}],"id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Difficult biliary cannulation during endoscopic retrograde cholangiopancreatography (ERCP) poses significant challenges and increases the risk of adverse events. Pancreatic guidewire (PGW)-assisted techniques offer potential solutions, but real-world comparative data are limited. Methods: This cohort study of prospectively collected data analyzed 234 ERCP cases from the Hungarian ERCP Registry, focusing on three PGW-assisted methods: transpancreatic sphincterotomy (TPS), double-guidewire technique (DGW), and prophylactic pancreatic stent-assisted cannulation (PPS-C). Results: TPS demonstrated the highest primary cannulation success rate (83.1%), significantly outperforming DGW (67.7%) and PPS-C (67.6%) (p &lt; 0.001). With salvage methods, cannulation success was high across all groups. Post-ERCP pancreatitis rates were low (5.0% TPS, 5.6% DGW, 3.9% PPS-C), but prophylactic measures (pancreatic stents, indomethacin) were underutilized. Conclusions: Our findings suggest that TPS is a safe and effective alternative for difficult biliary cannulation in ERCP. Routine considerations of post-ERCP pancreatitis prophylaxis (prophylactic pancreatic stents and non-steroidal suppositories) are recommended in all PGW-assisted cannulations to minimize complications.<\/jats:p>","DOI":"10.3390\/jcm14197118","type":"journal-article","created":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T13:47:08Z","timestamp":1760104028000},"page":"7118","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Transpancreatic Sphincterotomy Is a Safe and Effective Pancreatic Guidewire-Assisted Cannulation Method: Real-World Data Analysis of the Hungarian ERCP Registry"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0499-6004","authenticated-orcid":false,"given":"D\u00e1niel","family":"P\u00e9csi","sequence":"first","affiliation":[{"name":"Institute for Translational Medicine, Medical School, University of P\u00e9cs, 7624 P\u00e9cs, Hungary"},{"name":"Division of Interventional Gastroenterology, First Department of Medicine, Medical School, University of P\u00e9cs, 7624 P\u00e9cs, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5349-6527","authenticated-orcid":false,"given":"Nelli","family":"Farkas","sequence":"additional","affiliation":[{"name":"Institute for Translational Medicine, Medical School, University of P\u00e9cs, 7624 P\u00e9cs, Hungary"},{"name":"Institute for Bioanalysis, Medical School, University of P\u00e9cs, 7624 P\u00e9cs, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Szil\u00e1rd","family":"G\u00f3di","sequence":"additional","affiliation":[{"name":"Division of Interventional Gastroenterology, First Department of Medicine, Medical School, University of P\u00e9cs, 7624 P\u00e9cs, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P\u00e9ter","family":"Hegyi","sequence":"additional","affiliation":[{"name":"Institute for Translational Medicine, Medical School, University of P\u00e9cs, 7624 P\u00e9cs, Hungary"},{"name":"Centre of Translational Medicine, Semmelweis University, 1085 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Szentesi","sequence":"additional","affiliation":[{"name":"Institute for Translational Medicine, Medical School, University of P\u00e9cs, 7624 P\u00e9cs, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Istv\u00e1n","family":"Altorjay","sequence":"additional","affiliation":[{"name":"Gastroenterology Clinic, University of Debrecen, 4032 Debrecen, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tam\u00e1s","family":"Bakucz","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Central Hospital of Northern Pest\u2014Military Hospital, 1134 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c1kos","family":"Orb\u00e1n-Szil\u00e1gyi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Central Hospital of Northern Pest\u2014Military Hospital, 1134 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zolt\u00e1n","family":"Szepes","sequence":"additional","affiliation":[{"name":"First Department of Medicine, University of Szeged, 6720 Szeged, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6331-0802","authenticated-orcid":false,"given":"L\u00e1szl\u00f3","family":"Czak\u00f3","sequence":"additional","affiliation":[{"name":"First Department of Medicine, University of Szeged, 6720 Szeged, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c1rp\u00e1d","family":"Patai","sequence":"additional","affiliation":[{"name":"First Department of Gastroenterology and Medicine, Markusovszky University Teaching Hospital, 9700 Szombathely, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5271-0176","authenticated-orcid":false,"given":"Tibor","family":"Gy\u00f6keres","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Central Hospital of Northern Pest\u2014Military Hospital, 1134 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roland","family":"Fejes","sequence":"additional","affiliation":[{"name":"First Department of Medicine, Szent Gy\u00f6rgy University Teaching Hospital of County Fej\u00e9r, 8000 Sz\u00e9kesfeh\u00e9rv\u00e1r, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7231-3300","authenticated-orcid":false,"given":"Zsolt","family":"Dubravcsik","sequence":"additional","affiliation":[{"name":"B\u00e1cs-Kiskun County University Teaching Hospital, 6000 Kecskem\u00e9t, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2217-7686","authenticated-orcid":false,"given":"\u00c1ron","family":"Vincze","sequence":"additional","affiliation":[{"name":"Division of Interventional Gastroenterology, First Department of Medicine, Medical School, University of P\u00e9cs, 7624 P\u00e9cs, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,9]]},"reference":[{"key":"ref_1","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 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