Double-guidewire technique for difficult bile duct cannulation: why not insert a prophylactic pancreatic stent?

摘要

We read with interest the article by Herreros de Tajeda et al,1 "Double-guidewire technique for difficult bile duct cannulation: a multicenter, randomized, controlled trial." The technique consists of inserting a pancreatic guidewire to facilitate biliary cannulation by straightening the papilla and preventing repeated pancreatic cannulation.2 The authors' conclusion that this technique is not superior to the standard cannulation technique and possibly increases the risk of post-ERCP pancreatitis may lead endoscopists to disregard a technique that is safe and effective when properly used in well-selected cases.