弯头型造影导丝与超滑亲水性软头导丝在内镜胰胆管插管中的对比研究

目的评价弯头型血管造影导丝（泥鳅导丝）与超滑亲水性软头导丝（斑马导丝）在经内镜逆行胰胆管造影术（ERCP）插管中的效果优劣。方法196例患者随机分为泥鳅导丝组和斑马导丝组，均为98例，行导丝引导下的切开刀插管，首次插管如果10min未成功则交换导丝重新插管10min，如再次插管超过10min则视为插管失败，将采用其他辅助插管技术。观察插管时间、插管成功率，以及术后腹痛与淀粉酶情况。结果泥鳅导丝组首次插管成功率高于斑马导丝组（93．9％比86．7％，P〈0．05），但插管时间差异无统计学意义；交换导丝后，泥鳅导丝插管成功率仍然高于斑马导丝（76．9％比0．0％，P〈0．05）。术后淀粉酶升高与胰腺炎发生率两组间差异无统计学意义（P〉0．05）。结论泥鳅导丝ERCP插管优于斑马导丝，在困难插管时可以替代斑马导丝。

A prospective randomized controlled study of selective common bile duct cannulation guided by loach guide wire and zebra guide wire in ERCP

Objective To compare curve-tip angiography guide wire (loach guide wire) and ultrasmooth hydrophilic guide wire (zebra guide wire) in selective common bile duct (CBD) cannulation of endoscopic retrograde cholangiopancreatography (ERCP). Methods A total of 196 patients were randomly assigned to loach guide wire group to receive cannulation guided by loach guide wire first ( n = 98 ) and zebra guide wire group to use zebra guide wire first ( n =98). If cannulation was not successful after 10 minutes, a further attempt was made for an additional 10 minutes using the alternative guide wire. If still not successful after 10 minutes, other cannulation accessories would be used. The primary and overall selective cannulation time, success rate, and post-procedure abdominal pain and serum amylase were assessed. Results The primary success rate of selective CBD cannulation was higher in the loach guide wire group (93.9%) than that in zebra guide wire group (86. 7%, P ＜0. 05), while there was no significant difference in cannulation time between 2 groups (P ＞ 0. 05 ). The cannulation success rate after crossover was higher in loach guide wire group (76. 9% ) than that in zebra guide wire group (0. 0%, P ＜0. 05). There was no significant difference in post-procedure serum amylase or occurrence rate of post ERCP pancreatitis between 2 groups (P ＞ 0. 05 ).Conclusion Loach guide wire is superior to zebra guide wire in ERCP selective CBD cannulation, which can replace zebra guide wire in difficult cannulation.