Intraductal knot formation in a guidewire during ERCP - 16/08/11
Doi : 10.1016/j.gie.2006.05.011
| Commentary Complications attributable to guidewires used for ERCP are infrequent and include electrical short circuits, bile duct perforation, guidewire fracture, and intraductal knotting of the ERCP catheter as well as the guidewire. The wire used in this case combines a flexible coated Nitinol core with a floppy tungsten tip. Such wires allow the intentional formation of advancing loops or “knees” that can be useful in directing the guidewire into bilary sites that are difficult to access. It is likely that the repetitive back and forth movements of the wire within the duct when the wire was looped allowed knotting to occur. Biliary endoscopists should be alert to this potential complication and should carefully observe the behavior of the guidewire during all phases of its manipulation. Thankfully, ancient times have passed, knots are not tied from cornel bark, and the “Alexandrian solution” of slicing the (Gordian) knot with a sword is no longer necessary—not only to become King of Asia but to exit the biliary tree with no adverse sequelae. Lawrence J. Brandt, MD Associate Editor for Focal Points |
© 2006
American Society for Gastrointestinal Endoscopy. Publié par Elsevier Masson SAS. Tous droits réservés.
Vol 64 - N° 5
P. 815-816 - novembre 2006 Retour au numéro
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