# Thermal changes in guidewires used during endoscopic retrograde cholangiopancreatography during electrical conductance: Ex-vivo safety experiment

## TL;DR

This study tested how much heat is generated by guidewires during endoscopic procedures and found minimal risk of thermal injury.

## Contribution

The study provides empirical evidence on thermal safety of guidewires during electrocautery in endoscopic retrograde cholangiopancreatography.

## Key findings

- Most guidewires showed nominal thermal changes during electrical conductance.
- Minimally wrapped 0.018” wires had maximum temperature increases of 4.9°C and 6.8°C.
- Some wires produced sparks and had insulation defects under microscopic evaluation.

## Abstract

Risks of pancreaticobiliary tissue damage secondary to electrical conduction along cannulation wires in the vicinity of electrocautery have rarely been independently studied and remain mostly a theoretical issue. We aimed to evaluate heat generated by commercially available guidewires in the setting of currents used for sphincterotomy to assess their safety during endoscopic procedures. We tested heat generation from 11 common guidewires used in endoscopic retrograde cholangiopancreatography using an electrosurgical generator in combination with a thermocouple temperature probe in an ex vivo model. Thermal changes during electrical conductance were nominal except for minimally wrapped 0.018” wires where the maximum changes in temperature were 4.9°C with ENDO CUT Q settings and 6.8°C with ENDO CUT I settings. Also, the Glidewire 0.018” and the Visiglide 0.025” produced visible sparks along their distal ends with defects in insulation found later under microscopic evaluation. In our ex-vivo study, minimal heat was generated via electrical conductivity despite direct current, suggesting negligible risk of thermal injury during sphincterotomy.