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Endoscopy 2006; 38(7): 713-716
DOI: 10.1055/s-2006-925446
Original Article
© Georg Thieme Verlag KG Stuttgart · New York

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

A.  M.  Joyce1 , N.  A.  Ahmad1 , M.  C.  Beilstein1 , M.  L.  Kochman1 , W.  B.  Long1 , T.  Baron2 , S.  Sherman3 , E.  Fogel3 , G.  A.  Lehman3 , L.  McHenry Jr3 , J.  Watkins3 , G.  G.  Ginsberg1
  • 1 Division of Gastroenterology, Dept. of Medicine, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA
  • 2 Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
  • 3 Division of Gastroenterology and Hepatology, Indiana University Medical Center, Indianapolis, Indiana, USA
Further Information

Publication History

Submitted 5 December 2005

Accepted after revision 6 February 2006

Publication Date:
29 June 2006 (online)

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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.

References

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G. G. Ginsberg, M.D.

Division of Gastroenterology · Hospital of the University of Pennsylvania ·

3 Ravdin · 3400 Spruce Street · Philadelphia, PA 19104 · USA

Fax: +1-215-349-5915 ·

Email: gregory.g.ginsberg@uphs.upenn.edu

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