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Purpose Designed Portfolio for Biliary Access

 

Achieving reliable pancreatobiliary access is essential for delivering first time procedural success in many therapeutic endoscopic procedures, supporting everything from ductal access to interventions such as stone removal and stricture therapy.

These procedures often present complex and variable anatomical challenges, making consistency and versatility essential. Difficult cannulations with several attempts with or without contrast injection may increase the risk of post-ERCP pancreatitis (PEP), increase procedural time, resource use, and costs – affecting both clinical outcomes and operational efficiency.1

Luminal access-related Endoscopic Retrograde Cholangiopancreatography (ERCP) complications are well-documented:2,3

ComplicationRate
Post-ERCP pancreatitis3.5%-9.7%4 (rising to 14.7% in high-risk patients)
ERCP-related perforation1.5%5
Bleeding1.3%4 (29% of cases severe)
Infection (including cholangitis and cholecystitis)1.4%4

We offer adaptable, reliable tools to support you in navigating diverse scenarios with confidence, helping advance patient outcomes.

How Physician-Controlled ERCP Techniques Improve Access Control

Access in ERCP

Physician-controlled ERCP techniques involve the endoscopist directly manipulating both the endoscope and guidewire during cannulation, rather than delegating wire control to an assistant.

This approach provides immediate tactile feedback and greater control during duct access and has become a preferred method for many clinicians. It facilitates deep biliary duct cannulation without the need for standard contrast-assisted techniques, while maintaining efficient cannulation without increased complication rates.

The RX Biliary System™ is designed with these needs in mind, enabling access and control in ERCP by:

  • Putting the physician in control of the guidewire
  • Securing the guidewire to maintain access during exchanges
  • Ensuring a tactile feel during manipulation of the guidewire6,7
Find out more about the RX Biliary System™

  

Benefits of Physician-Controlled ERCP Techniques

Clinical evidence documents multiple benefits to patients and healthcare systems, including:

Reduced post-operative complications

In a study, patients who underwent endoscopist-controlled wire-guided cannulation experienced a statistically significant lower rate of post-ERCP complications compared with assistant-controlled wire-guided cannulation.6

Reduced risk of post-ERCP pancreatitis

Physician-controlled wire-guided cannulation has also been shown to reduce the risk of post-ERCP pancreatitis by 8.4%, compared with the standard contrast injection method.4,6

Reduced procedure time

By reducing exchange time by 52 seconds compared with assistant-controlled systems, and enabling stent insertion 119 seconds faster,5 short-wire technology shortens overall procedure duration and reduces the time required for both sedation and fluoroscopy.

Proven Access Solutions for Every ERCP Technique

At Boston Scientific, we provide solutions designed to address the complexities of ERCP access and support first-time success. Our purpose-designed portfolio enables confident and efficient biliary and pancreatic access, helping clinicians maintain control and support smooth progression throughout the procedure.3,6

Guidewires That Fit Your Needs

Physician-controlled wire guided cannulation ERCP techniques have become a preferred approach for many clinicians, offering control and efficiency during complex pancreatobiliary interventions. Tools that allow direct physician management of the guidewire and secure its position during device exchanges can help standardise performance and reduce procedural variability.

Our comprehensive portfolio of guidewires supports precise, controlled navigation during ERCP procedures. Our range of options are designed to offer clinical flexibility, enabling selection of the most appropriate guidewire for different procedural needs and anatomical challenges.

Available configurations include wire lengths of 260cm and 450cm, and distal tip outer diameters ranging from 0.025 to 0.035 inches. These specifications support compatibility across a variety of procedural techniques and preferences.

Dreamwire™ High Performance Guidewire

10cm hydrophilic Dream Tip™ end, designed to support soft, smooth access during guidewire advancement.

Explore Dreamwire™ High Performance Guidewire

Jagwire™ High Performance Guidewire

Hydrophilic tip combined with a supportive shaft, designed to balance access and control during navigation.

Explore Jagwire™ High Performance Guidewire

Jagwire™ Revolution High Performance Guidewire

0.025 inch guidewire, engineered to provide stiffness and pushability to support guidewire advancement.

Explore Jagwire™ Revolution High Performance Guidewire

Hydra Jagwire™ High Performance Guidewire

Dual-tip guidewire includes a 10 cm/5cm hydrophilic tip, enabling use of one or both tips during the procedure depending on preference.

Explore Hydra Jagwire™ High Performance Guidewire

NaviPro™ Hydrophilic Guidewire

100% hydrophilic guidewire, designed to support cannulation and enable smooth passage through tortuous anatomy during guidewire advancement.

Explore NaviPro™ Hydrophilic Guidewire

Locking Device for Secure Placement

Our locking device is designed to facilitate physician-controlled guidewire placement and device exchanges during ERCP. With no preparation required, AutoCap™ RX provides simple, secure attachment to the scope, minimises leakage of biomaterial, and maintains insufflation.

AutoCap™ RX Integrated Biopsy Cap and Guidewire Locking Device

Explore AutoCap™ RX Integrated Biopsy Cap and Guidewire Locking Device

Precision-Engineered Tomes

Our tomes are designed to simplify selective ductal access and sphincterotomy in complex ERCP procedures, supporting navigation of challenging anatomy with greater precision and control. By streamlining ductal access, they support efficient, controlled interventions where procedural complexity may otherwise impact progression.

Preloaded sphincterotome options are included to reduce preparation time and support a more efficient ERCP workflow. This enables faster procedure progression while maintaining performance and control during biliary and pancreatic access.

Autotome™ Pro RX Cannulating Sphincterotome

DirecTip™ technology enables guidewire and contrast to be directed from the center of the tip to support positioning and facilitate cannulation. Tip control features support device placement and passability*.

Explore Autotome™ Pro RX Cannulating Sphincterotome

Autotome™ RX Cannulating Sphicterotome

Cannulating sphincterotome, designed to provide controlled steerability to support positioning and facilitate sphincterotomy during ERCP procedures.

Explore Autotome™ RX Cannulating Sphicterotome

Jagtome™ RX Cannulating Sphincterotome

Short-wire device preloaded with a Jagwire™ High Performance Guidewire, designed to help reduce procedure preparation time.

Explore Jagtome™ RX Cannulating Sphincterotome

Jagtome™ Revolution RX Cannulating Sphincterotome

Preloaded wire-guided sphincterotome, indicated for selective duct cannulation, contrast injection, and sphincterotomy.

Explore Jagtome™ Revolution RX Cannulating Sphincterotome

Hydratome™ RX Cannulating Sphincterotome

100% hydrophilic guidewire, designed to support cannulation and enable smooth passage through tortuous anatomy during guidewire advancement.

Explore Hydratome™ RX Cannulating Sphincterotome

Dreamtome™ RX Cannulating Sphincterotome

Dreamwire™ guidewires, available in long-wire and short-wire configurations. The Dreamtome RX Cannulating Sphincterotome is preloaded with a Dreamwire™ High Performance Guidewire to help reduce procedure preparation time.

Explore Dreamtome™ RX Cannulating Sphincterotome

TrueTome™ Cannulating Sphincterotome

Truetome™ supports cannulation and sphincterotomy in a single device. Center-lumen design enables guidewire and contrast exit from the tip to aid positioning and control.

Explore TrueTome™ Cannulating Sphincterotome

   

Explore our Full ERCP Portfolio further

Explore our ERCP portfolio designed to support controlled cannulation, enable efficient therapy, and help manage complex cases with confidence.

See our full Stone Management portfolio

Discover our Stricture Management solutions

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Product catalogue​

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*With Autotome™ RX Pro 39 and 44 only.

References

1. Testoni PA, et al. Endoscopy. 2016;48(7):657-83.

2. Dumonceau JM, et al. Endoscopy. 2020;52(2):127-49.

3. Patil NS, et al. Surg Endosc. 2020;34(1):77-87.

4. ASGE Technology Committee, et al. Gastrointest Endosc. 2007;66(4):650-7.

5. Maceček J et al. Gastroenterol Hepatol. 2021;75:200-6.

6. Buxbaum J, et al. Am J Gastroenterol. 2016;111(12):1841-7.

7. Draganov PV, et al. Dig Dis Sci. 2010;55(2):510-5.

CAUTION: The law restricts these devices to sale by or on the order of a physician. Indications, contraindications, warnings, and instructions for use can be found in the product labelling supplied with each device or at www.IFU-BSCI.com. Products shown for INFORMATION purposes only and may not be approved or for sale in certain countries. This material not intended for use in France.