The University of Toledo Translation Journal of Medical Sciences 
Gastroenterology Abstract, Department of Medicine Research Symposium UTJMS 2023 May 5; 11(1):e1-e1 

Impact of Guidewire Caliber on ERCP Outcomes: 
Systematic Review and Meta-Analysis Comparing 0.025- 
and 0.035-Inch Guidewires 

Muhammad Aziz 1*, Amna Iqbal1, Zohaib Ahmed1, Saad Saleem1, Wade Lee-Smith2, Hemant Goyal1, 
Faisal Kamal1, Yaseen Alastal1, Ali Nawras1, Douglas G Adler3 

1Division of Gastroenterology and Hepatology, Department of Medicine, The 
University of Toledo, Toledo, OH 43614 
2Department of University Libraries, The University of Toledo, Toledo, OH 43614 
3Director of Therapeutic Endoscopy and Director of Gastroenterology Fellowship 
Training Program University of Utah, School of Medicine, Salt Lake City, UT 84132 

*Corresponding author: Muhammad.Aziz@utoledo.edu

Published: 05 May 2023 

Background and Study Aims: The impact of guidewire caliber on endoscopic retrograde 
pancreatography (ERCP) outcomes are not clear. Recent studies have compared two guidewires, 0.035- 
and 0.025-inch, in randomized controlled trials (RCTs). We performed a systematic review and meta-
analysis of available RCTs to assess if different caliber would change the outcomes in ERCP. 

Patients and Methods: A systematic search of PubMed/Medline, Embase, Cochrane, SciELO, Global 
Index Medicus and Web of Science was undertaken through November 23, 2021 to identify relevant 
RCTs comparing the two guidewires. Binary variables were compared using random effects model and 
DerSimonian-Laird approach. For each outcome, risk-ratio (RR), 95 % confidence interval (CI), and P 
values were generated. P < 0.05 was considered significant.  

Results: Three RCTs with 1079 patients (556 in the 0.035-inch group and 523 in the 0.025-inch group) 
were included. The primary biliary cannulation was similar in both groups (RR: 1.02, CI: 0.96-1.08, P = 
0.60). The overall rates of PEP were also similar between the two groups (RR: 1.15, CI: 0.73-1.81, P = 
0.56). Other outcomes (overall cannulation rate, cholangitis, perforation, bleeding, use of adjunct 
techniques) were also comparable. 

Conclusion: The results of our analysis did not demonstrate a clear benefit of using one guidewire over 
other. The endoscopist should consider using the guidewire based on his technical skills and 
convenience. 

https://dx.doi.org/10.46570/utjms.vol11-2023-654 

https://dx.doi.org/10.46570/utjms.vol11-2023-654
mailto:Muhammad.Aziz@utoledo.edu