HOW TO MAKE THE PANCREATIC GUIDEWIRE METHOD SUCCESSFUL?

Abstract

The pancreatic guidewire (PGW) method is widely used in clinical practice as an option for cases where biliary cannulation is difficult. Placing a guide wire in the pancreatic duct is expected to lead to the fixation of the papilla and straightening of the bile duct in the papilla. However, although the placement of the guidewire in the pancreatic duct makes it possible to suppress the mobility of the papilla itself, it is not possible to completely straighten the flexed intrapapillary bile duct. The endoscopists should always keep this fact in mind.

The PGW method is only one of several options, and successful biliary cannulation cannot be achieved without constructing an intubation strategy based on the morphology of the facing papilla, the shape of the oral protrusion, and the scope position after the placement of the pancreatic duct guidewire.

While the risk of post-operative pancreatitis should always be assumed, it is necessary to logically and protectively manipulate the safety and reliability of the placement of pancreatic duct guidewires and the proper use of various cannulation methods, depending on the case.