Two Kinds of Guide Wire Contrast Research in Selective Bile Duct Intubation

Two Kinds of Guide Wire Contrast Research in Selective Bile Duct Intubation

Med J of Communications,2012,Vol.26.No.6.

Nantong No. 1 People Hospital Digestive Department

Endoscopic retrograde cholangiopancreatography (ERCP) is playing an increasingly important role in minimally invasive interventional therapy of pancreatic and biliary diseases. Selective cholangiopancreatic intubation is the first and critical step in the successful operation of ERCP for both diagnosis and treatment. As one of the commonly used instruments in ERCP operation, the guide wire plays an important role in the process of ERCP. Especially for the difficult cases of ERCP, the success of guide wire application is related to the success of ERCP diagnosis and treatment.

This paper compared the application effect of two kinds of guide wire in selective bile duct intubation, which were 282 cases of ERCP examination in our hospital from January 2011 to October 2012. 140 cases of zebra guide wire and 142 cases of dream guide wire were used respectively. The application effect of zebra guide wire and dream guide wire in selective bile duct intubation was compared.

A total of 282 patients with ERCP indications were randomly divided into 2 groups, 140 cases in the zebra guide wire group and 142 cases in the dream guide wire group. The successful rate, intubation time, and the incidence of hyperamylase and pancreatitis after ERCP were compared between the two groups.

Two product parameters:

Zebra guide wire is 450cm long, diameter 0.91mm, with 5cm hydrophilic opaque X-ray head.

Dream guide wire is 260cm long, diameter 0.89mm, with 10cm long radiopaque hydrophilic soft tip. 

Results: 

In the dream guide wire group, there were 140 cases. 76 cases (54.3%) successfully intubated for the first time, and 34 cases were successfully intubated with cross intubation. Totally 110 cases were successfully intubated. 

In the dream guide group, there were 142 cases. 115 cases (81.0%) were successfully intubated for the first time, and 4 cases were successfully intubated with cross intubation. Totally 119 cases were successfully intubated. 

The success rate of initial intubation was significantly different between the two groups, which has statistical significance (P<0.05).

The time of initial intubation was 3.55±0.36 s in the zebra guide wire group and 4.38± 0.32s in the dream guide wire group, and the difference between the two groups was not statistically significant (P>0.05). The total intubation time was 6.31± 0.52s in the zebra guide wire group and 6.87 ±0.37s in the dream guide wire group, and the difference between the two groups was not statistically significant (P>0.05).

Postoperative hyperamylase occurred in 26 cases (18.6%) in the zebra guide wire group and 21 cases (14.8%) in the dream guide wire group, with no statistically significant difference between the two groups (P>0.05).

There were 6 cases (4.3%) of postoperative pancreatitis in the zebra guide wire group and 5 cases (3.5%) in the dream guide wire group. There was no significant difference between the two groups (P>0.05).

Different from the ordinary zebra guide wire, the dream guide wire core is made of special alloy. The guide wire is sealed in the PTFE core sleeve with stripes, with a 10cm long opaque hydrophilic tip at the far end. As the guide wire is very smooth, hydrophilic tip can be reflexed so as to enter through the narrow gap when encountered with obstruction, so it has advantages when passing through some twisted, narrow and angular cavities.

In selective cholangial intubation, dream guide wire has a higher success rate than zebra guide wire, which is worthy of clinical application.