Deep cannulation is a prerequisite for successful endoscopic retrograde
cholangiopancreatography (ERCP) procedures. Of the biliary procedures, stenting is one
of the most common. This study was carried out to investigate current and controversial
issues regarding biliary cannulation and stenting.
The double guidewire (DGW) technique was studied to analyze its safety and feasibility
in biliary cannulation as a single procedure and as a part of the novel three-step
cannulation protocol. Female gender was evaluated in regard to difficult cannulation.
The use of an angled and a straight tipped guidewire in biliary cannulation was studied in
a prospective, randomized trial. Additionally, the patency of the novel antireflux plastic
biliary stent was compared to the patency of the conventional plastic biliary stent in a
prospective, randomized setting.
The DGW method seems safe and feasible as an alternative cannulation technique in
biliary cannulation. Female gender was not associated significantly with difficult biliary
cannulation in our study, although the cannulation times seemed to be longer and the
alternative cannulation techniques seemed to be needed more often in females than
males. According to the results of this thesis, an angled tipped guidewire may facilitate
biliary cannulation. In controversy to the previous result presented in the literature, the
antireflux plastic biliary stent tested herein should not be used, as the patency of the stent
was significantly shorter compared to the conventional plastic stent.Siirretty Doriast
