Multicenter comparative trial of the V-scope system for therapeutic ERCP

A. M. Joyce, N. A. Ahmad, M. C. Beilstein, M. L. Kochman, W. B. Long, T. Baron, S. Sherman, E. Fogel, G. A. Lehman, L. McHenry, J. Watkins, Gregor G. Ginsberg

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Abstract

Background and study aims: A new duodenoscope (the V-scope), with a modified elevator used in combination with a dedicated short guide wire, constitutes the V-system. This system is intended to allow fixation of the guide wire at the elevator lever, thereby enhancing the speed and reliability of accessory exchange over a guide wire during ERCP. The aim of this study was to evaluate the extent to which the V-system provides improved efficiency in comparison with conventional duodenoscope and guide wire combinations. Patients and methods: This was an industry-sponsored multicenter randomized trial. Patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) procedures in which treatment was anticipated were randomly assigned to the V-system or to a conventional duodenoscope and accessories used routinely in each center. The parameters recorded included the total case time, fluoroscopy time, catheter/guide wire exchange time, guide wire repositioning, loss of guide wire access, and success or failure of guide wire fixation when using the V-system. Results: Fifty patients were included, 22 in the conventional group and 28 in the V-system group. A total of 135 exchanges were carried out. The patients had up to six exchanges. The median exchange time was 19.4 s with the V-system and 31.7 s with the conventional systems (P < 0.001). Guide wire repositioning was required less often in the V-system group (P = 0.0005). The V-system effectively locked the guide wire in 63 of 71 exchanges (89%). Loss of guide wire access occurred in two patients in the conventional group and four in the V-system group, attributable to failure to lock the guide wire early during the experience (no significant differences). Conclusions: The V-system can effectively secure the guide wire during accessory exchange in ERCP and reduces the time required to exchange accessories. This may enhance overall efficiency during ERCP.

Original languageEnglish (US)
Pages (from-to)713-716
Number of pages4
JournalEndoscopy
Volume38
Issue number7
DOIs
StatePublished - Jul 1 2006

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ASJC Scopus subject areas

  • Gastroenterology

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Joyce, A. M., Ahmad, N. A., Beilstein, M. C., Kochman, M. L., Long, W. B., Baron, T., Sherman, S., Fogel, E., Lehman, G. A., McHenry, L., Watkins, J., & Ginsberg, G. G. (2006). Multicenter comparative trial of the V-scope system for therapeutic ERCP. Endoscopy, 38(7), 713-716. https://doi.org/10.1055/s-2006-925446