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https://www.readbyqxmd.com/read/28230608/specialized-imaging-and-procedures-in-pediatric-pancreatology-a-north-american-society-for-pediatric-gastroenterology-hepatology-and-nutrition-clinical-report
#1
Tom K Lin, David M Troendle, Daniel B Wallihan, Bradley Barth, Victor L Fox, Douglas S Fishman, Veronique D Morinville
OBJECTIVES: An increasing number of children are being diagnosed with pancreatitis and other pancreatic abnormalities. Dissemination of the information regarding existing imaging techniques and endoscopic modalities to diagnose and manage pancreatic disorders in children is sorely needed. METHODS: We conducted a review of the medical literature on the use of the following imaging and procedural modalities in pediatric pancreatology: transabdominal ultrasonography (TUS), computed tomography (CT), magnetic resonance imaging (MRI)/magnetic resonance cholangiopancreatography (MRCP), endoscopic ultrasonography (EUS), and endoscopic retrograde cholangiopancreatography (ERCP)...
March 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28208000/two-cases-of-plug-or-stone-in-remnant-intrapancreatic-choledochal-cysts-treated-with-endoscopic-retrograde-cholangiopancreatography
#2
Eunbee Kim, Min Ho Kang, Jisun Lee, Hanlim Choi, Jae-Woon Choi, Joung-Ho Han, Seon Mee Park
Incomplete resection of choledochal cysts (CCs) that extend deep into the pancreas can lead to protein plug or stone formation, pancreatitis, and cholangiocarcinoma. We encountered two cases of choledocholithiasis in remnant intrapancreatic CCs (IPCCs), in which the patients exhibited symptoms after 3 and 21 years of cyst excision. A 21-year-old woman who had undergone excision of a CC, as a neonate, presented with epigastric pain. Abdominal computed tomography (CT) revealed stones inside the remnant pancreatic cyst, which were removed by endoscopic retrograde cholangiopancreatography (ERCP), and her symptoms improved...
February 16, 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/28188033/success-and-safety-of-endoscopic-retrograde-cholangiopancreatography-in-children
#3
Jordan D Rosen, Rebecca S Lane, Jose M Martinez, Eduardo A Perez, Jun Tashiro, Amy E Wagenaar, Robert M Van Haren, Ashwini Kumar, Juan E Sola
PURPOSE: Despite its diagnostic and therapeutic utility, endoscopic retrograde cholangiopancreatography (ERCP) is underutilized in children. METHODS: Patients younger than 18years undergoing ERCP from 2000 to 2014 at a children's hospital were identified. Patient characteristics and outcomes were evaluated. RESULTS: Overall, 215 ERCPs (78% therapeutic) were performed in 184 patients. Our cohort was 67% female, with a median age (IQR) of 14 (8) years...
February 1, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28171691/toward-routine-use-of-nonsteroidal-anti-inflammatory-drugs-for-patients-undergoing-endoscopic-retrograde-cholangiopancreatography
#4
EDITORIAL
Tsuyoshi Hamada, Yousuke Nakai, Hiroyuki Isayama, Kazuhiko Koike
Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most widely used pharmacological prevention strategy for post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP).(1,2) Experimental data suggest that NSAIDs, a group of inhibitors of PTGS1 (cyclooxygenase-1 or COX-1) and PTGS2 (cyclooxygenase-2 or COX-2), can prevent PEP through inhibition of phospholipase A2 which plays a key role in triggering inflammatory response in the pancreas.(3) Given accumulating evidence from clinical trials, peri-procedural use of rectal NSAIDs is considered as an established strategy for prevention of PEP, at least for patients who have risk factors for PEP including younger age, suspected sphincter of Oddi dysfunction as an indication, and a history of pancreatitis...
February 7, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28081547/diagnosis-of-pancreaticobiliary-malignancy-by-detection-of-minichromosome-maintenance-protein-5-in-biliary-brush-cytology
#5
Margaret G Keane, Matthew T Huggett, Michael H Chapman, Gavin J Johnson, George J Webster, Douglas Thorburn, James Mackay, Stephen P Pereira
BACKGROUND: Biliary brush cytology is the standard method of evaluating biliary strictures, but is insensitive at detecting malignancy. In pancreaticobiliary cancer minichromosome maintenance replication proteins (MCM 2-7) are dysregulated in the biliary epithelium and MCM5 levels are elevated in bile samples. This study aimed to validate an immunocolorimetric ELISA assay for MCM5 as a pancreaticobiliary cancer biomarker in biliary brush samples. METHODS: Biliary brush specimens were collected prospectively at ERCP from patients with a biliary stricture...
January 2017: British Journal of Cancer
https://www.readbyqxmd.com/read/28054294/treatment-of-common-bile-duct-stones-in-gastric-bypass-patients-with-laparoscopic-transgastric-endoscopic-retrograde-cholangiopancreatography
#6
Nina A Frederiksen, Louise Tveskov, Frederik Helgstrand, Lars Naver, Andrea Floyd
BACKGROUND: Laparoscopic Roux-en-Y gastric bypass excludes the biliary tree from traditional evaluation and treatment with endoscopic retrograde cholangiopancreatography (ERCP). Due to the initial rapid weight loss, gastric bypass patients have an increased risk of developing gallstones in the gallbladder as well as in the common bile duct. Various techniques to access the biliary tree have been described. The techniques are characterised by complexity and varying results. The aim of the present study was to assess both feasibility and outcome of laparoscopic-assisted transgastric ERCP in patients with gastric bypass...
January 4, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28042392/combination-of-two-hour-post-endoscopic-retrograde-cholangiopancreatography-amylase-levels-and-cannulation-times-is-useful-for-predicting-post-endoscopic-retrograde-cholangiopancreatography-pancreatitis
#7
Shiro Hayashi, Tsutomu Nishida, Hiromi Shimakoshi, Akiyoshi Shimoda, Takahiro Amano, Aya Sugimoto, Kei Takahashi, Kaori Mukai, Tokuhiro Matsubara, Masashi Yamamoto, Sachiko Nakajima, Koji Fukui, Masami Inada
AIM: To estimate the efficacy of 2 h post-endoscopic retrograde cholangiopancreatography (ERCP) serum amylase levels and other factors for predicting post-ERCP pancreatitis. METHODS: This was a retrospective, single-center cohort study of consecutive patients who underwent ERCP from January 2010 to December 2013. Serum amylase levels were measured 2 h post-procedure, and patient- and procedure-related pancreatitis (PEP) risk factors were analyzed using a logistic model...
December 16, 2016: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28039647/a-multicenter-experience-of-through-the-scope-balloon-assisted-enteroscopy-in-surgically-altered-gastrointestinal-anatomy
#8
Jennifer X Cai, David L Diehl, Ralf Kiesslich, Andrew C Storm, Mohamad H El Zein, Alan H Tieu, Arthur Hoffman, Vikesh K Singh, Mouen A Khashab, Patrick I Okolo, Vivek Kumbhari
BACKGROUND: Surgically altered gastrointestinal anatomy poses challenges for deep enteroscopy. Current overtube-assisted methods have long procedure times and utilize endoscopes with smaller working channels that preclude use of standard accessories. A through-the-scope balloon-assisted enteroscopy (TTS-BAE) device uses standard endoscopes with a large working channel to allow metallic and plastic stent insertion. We aim to determine the efficacy and safety of TTS-BAE in patients with altered surgical anatomy...
December 30, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/28027817/management-of-endoscopic%C3%A2-retrograde-cholangiopancreatography-related-perforations-experience-of-a-tertiary-center
#9
Roi Weiser, Niv Pencovich, Liat Mlynarsky, Adi Berliner-Senderey, Guy Lahat, Erwin Santo, Joseph M Klausner, Ido Nachmany
BACKGROUND: Endoscopic retrograde cholangiopancreatography-induced perforation (EP) is a rare but severe complication. We describe the risk factors, management, and outcome of ERCP-induced perforations in a tertiary center. METHODS: This is a case-control study. All EP cases between March 2004 and February 2015 were compared to a control group without perforation. Data on patients, procedures, presentation, perforation type, radiologic findings, management, and outcome were assessed...
December 24, 2016: Surgery
https://www.readbyqxmd.com/read/27999591/endoscopic-management-of-the-difficult-bile-duct-stones-a-single-tertiary-center-experience
#10
Bülent Ödemiş, Ufuk Barış Kuzu, Erkin Öztaş, Fatih Saygılı, Nuretdin Suna, Orhan Coskun, Adem Aksoy, Zeliha Sırtaş, Derya Arı, Yener Akpınar
Background. Most common bile duct (CBD) stones can be removed with standard techniques using endoscopic retrograde cholangiopancreatography (ERCP), but in some cases additional methods are needed. In this study we aimed to investigate the management of patients with difficult stones and the factors that affect the outcome of patients that have undergone periodic endobiliary stenting. Materials and Methods. Data of 1529 patients with naive papilla who had undergone ERCP with an indication of CBD stones was evaluated retrospectively...
2016: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/27995197/eus-guided-biliary-drainage-or-enteroscopy-assisted-ercp-in-patients-with-surgical-anatomy-and-biliary-obstruction-an-international-comparative-study
#11
Mouen A Khashab, Mohamad H El Zein, Kaveh Sharzehi, Fernando P Marson, Oleh Haluszka, Aaron J Small, Yousuke Nakai, Do Hyun Park, Rastislav Kunda, Anthony Y Teoh, Irene Peñas, Manuel Perez-Miranda, Vivek Kumbhari, Schalk Van der Merwe, Everson L Artifon, Andrew S Ross
Background and study aims: How enteroscopy-assisted ERCP (e-ERCP) and endoscopic ultrasound-guided biliary drainage (EUS-BD) compare in patients with surgically altered upper gastrointestinal anatomy is currently unknown. The aims of this study were to compare efficacy and safety of both techniques and study predictors of these outcomes. Patients and methods: This was an international, multicenter comparative cohort study at 10 tertiary centers. Outcomes data included technical success (biliary access with cholangiography and stent placement [when indicated]), clinical success (resolution of biliary obstruction) and adverse events (AEs) (graded according to the ASGE lexicon)...
December 2016: Endoscopy International Open
https://www.readbyqxmd.com/read/27965473/diagnostic-value-of-endoscopic-ultrasonography-in-symptomatic-patients-with-high-and-intermediate-probabilities-of-common-bile-duct-stones-and-a-negative-computed-tomography-scan
#12
Tae Joo Jeon, Jae Hee Cho, Yeon Suk Kim, Si Young Song, Ji Young Park
Background/Aims: When computed tomography (CT) does not indicate choledocholithiasis in highly suspicious patients, there is no definite consensus on the subsequent modality. Endoscopic ultrasonography (EUS) indicates fewer procedure-related complications than endoscopic retrograde cholangiopancreatography (ERCP) and has a lower cost than magnetic resonance cholangiopancreatography. Therefore, we aimed to investigate the diagnostic value of EUS in patients with suspected choledocholithiasis and negative CT findings...
December 16, 2016: Gut and Liver
https://www.readbyqxmd.com/read/27958287/ocular-radiation-threshold-projection-based-off-of-fluoroscopy-time-during-ercp
#13
Mrinal S Garg, Pikul Patel, Margaret Blackwood, Satish Munigala, Payal Thakkar, James Field, Dustin Wallace, Satty Agarwal, Elie Aoun, Abhijit Kulkarni, Manish Dhawan, Katie Farah, Shyam Thakkar
OBJECTIVES: Current international guidelines for ocular radiation exposure suggest a threshold of 20 millisieverts (mSv)/year. Although endoscopists wear lead aprons, use of protective eye wear is optional. This study was conducted to analyze the lens radiation exposure during endoscopic retrograde cholangiopancreatography (ERCP) for endoscopists to determine the time of fluoroscopy needed to warrant using lens protection during ERCP. METHODS: ERCP patients were prospectively enrolled...
December 13, 2016: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/27931639/complications-in-pediatric-endoscopy
#14
REVIEW
Andrea Tringali, Valerio Balassone, Paola De Angelis, Rosario Landi
The experience of the "endoscopic community" in pediatric patients is limited, but during recent years increased skills of the endoscopists and technological improvements lead to a standardization of pediatric endoscopy and the development of specialized pediatric endoscopy unit. Adverse events related to diagnostic and therapeutic endoscopy in children are usually rare. Diagnosis, prevention and treatment of complications in pediatric endoscopy is crucial when dealing with benign diseases in children. The complication rate of diagnostic EGD and colonoscopy in children are extremely low...
October 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27931638/complications-of-diagnostic-and-therapeutic-endoscopic-ultrasound
#15
REVIEW
Sundeep Lakhtakia
Endoscopic Ultrasound (EUS) provides the unique opportunity to visualize, interrogate and intervene gastrointestinal (GI) luminal, mural or peri-luminal structures and pathology with negligible adverse effects. Diagnostic, upper GI and rectal EUS is feasible, extremely safe, and efficacious. Most EUS guided interventions are safe, effective and minimally invasive, compared to peers in the percutaneous radiological or surgical procedures. As with any endoscopic procedure, EUS and its guided interventions may be accompanied by adverse events...
October 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27914884/clinical-presentation-diagnosis-and-survival-in-cholangiocarcinoma-a-prospective-study
#16
Larisa Vasilieva, Stefanos I Papadhimitriou, Alexandra Alexopoulou, Ioannis Kostopoulos, Konstantinos Papiris, Dimitrios Pavlidis, Dimitrios Xinopoulos, Andreas Romanos, Spyridon P Dourakis
BACKGROUND AND STUDY AIMS: The diagnosis of cholangiocarcinoma (CCA) is difficult. The present study aimed to assess the clinical features, diagnosis, and survival in CCA. PATIENTS AND METHODS: This is a prospective study on 46 patients with CCA who underwent endoscopic retrograde cholangiopancreatography (ERCP) or surgical resection and 20 controls with a clinical and ERCP suspicion for CCA in whom surgical biopsy and/or 4-year follow-up showed a benign biliary stricture...
December 2016: Arab Journal of Gastroenterology: the Official Publication of the Pan-Arab Association of Gastroenterology
https://www.readbyqxmd.com/read/27905178/follow-up-to-determine-unplanned-hospitalization-and-complications-after-endoscopic-retrograde-cholangiopancreatography
#17
Edwina Chan, Teresa Neeman, Andrew Thomson
BACKGROUND: Studies of endoscopic retrograde cholangiopancreatography (ERCP)-related complications are inconsistent and sometimes have insufficient patient follow-up. The aim of this study was to investigate risk factors for ERCP-related events, leading to hospitalization in the case of outpatients and prolonged hospital stay in the case of inpatients, using assiduous follow-up and contemporaneous recording of data. METHODS: Prospectively collected data of 1000 consecutive ERCP procedures performed by a single endoscopist at a tertiary referral centre in Canberra, Australia, were studied and the complications evaluated...
December 1, 2016: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/27893641/routine-surveillance-cholangiography-after-percutaneous-cholecystostomy-delays-drain-removal-and-cholecystectomy
#18
Tyler J Loftus, Scott C Brakenridge, Frederick A Moore, Camille G Dessaigne, George A Sarosi, William J Zingarelli, Janeen R Jordan, Chasen A Croft, R Stephen Smith, Philip A Efron, Alicia M Mohr
INTRODUCTION: Percutaneous cholecystostomy (PC) is often performed for patients with acute cholecystitis who are at high risk for operative morbidity and mortality. However, the necessity for routine cholangiography after PC remains unclear. We hypothesized that routine surveillance cholangiography (RSC) after PC would provide no benefit compared to on-demand cholangiography (ODC) triggered by signs or symptoms of biliary pathology. METHODS: We performed a 3-year retrospective cohort analysis of patients managed with PC for acute cholecystitis at two tertiary care hospitals...
February 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27875357/optimal-timing-of-endoscopic-retrograde-cholangiopancreatography-in-acute-cholangitis
#19
Linda A Hou, Loren Laine, Nima Motamedi, Ara Sahakian, Christianne Lane, James Buxbaum
OBJECTIVES: Acute cholangitis mandates resuscitation, antibiotic therapy, and biliary decompression. Our aim was to define the optimal timing of endoscopic retrograde cholangiopancreatography (ERCP) for patients with acute cholangitis. METHODS: Clinical data on all cases of cholangitis managed by ERCP were prospectively collected from September 2010 to July 2013. The clinical impact of the time to ERCP, defined as the time from presentation in the emergency department to the commencement of the ERCP, was determined...
November 21, 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/27862346/indications-for-endoscopic-ultrasonography-eus-guided-biliary-intervention-does-eus-always-come-after-failed-endoscopic-retrograde-cholangiopancreatography
#20
Yousuke Nakai, Hiroyuki Isayama, Natsuyo Yamamoto, Saburo Matsubara, Hirofumi Kogure, Suguru Mizuno, Tsuyoshi Hamada, Naminatsu Takahara, Rie Uchino, Dai Akiyama, Kaoru Takagi, Takeo Watanabe, Gyotane Umefune, Kazunaga Ishigaki, Minoru Tada, Kazuhiko Koike
BACKGROUND AND AIM: Endoscopic ultrasonography-guided biliary drainage (EUS-BD), first reported as an alternative to percutaneous transhepatic biliary drainage (PTBD) after failed endoscopic retrograde cholangiopancreatography (ERCP), is increasingly reported as a primary procedure without failed ERCP. The present study aims to evaluate the outcomes of therapeutic biliary ERCP and to compare the safety and effectiveness of primary EUS-BD with those of ERCP, rescue EUS-BD and PTBD. METHODS: We retrospectively studied therapeutic biliary ERCP as well as subsequent rescue PTBD and EUS-BD...
October 19, 2016: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
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