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ERCP indications

Danielle Usatin, Melissa Fernandes, Isabel E Allen, Emily R Perito, James Ostroff, Melvin B Heyman
OBJECTIVES: To systematically review risks and summarize reported complication rates associated with the performance of endoscopic retrograde cholangiopancreatography (ERCP) in children during the past 2 decades. STUDY DESIGN: A systematic literature search of MEDLINE, Embase, and Web of Science from January 1995 to January 2016 was conducted for observational studies published in English. Studies reporting ERCP complications in patients <21 years without history of liver transplant or cholecystectomy were included...
September 20, 2016: Journal of Pediatrics
Mar Concepción-Martín, Cristina Gómez-Oliva, Ana Juanes, Josefina Mora, Silvia Vidal, Xavier Díez, Xavier Torras, Sergio Sainz, Candid Villanueva, Antoni Farré, Carlos Guarner-Argente, Carlos Guarner
The most reliable indicators for post-ERCP acute pancreatitis are elevated amylase levels and abdominal pain 24 hours after ERCP. As ERCP is often performed on an outpatient basis, earlier diagnosis is important. We aimed to identify early predictors of post-ERCP pancreatitis. We prospectively analyzed IL-6, IL-10, TNFα, CRP, amylase and lipase before and 4 hours after ERCP, and studied their association with abdominal pain. We included 510 patients. Post-ERCP pancreatitis occurred in 36 patients (7.1%)...
2016: Scientific Reports
Ken Liu, Vikram Joshi, Payal Saxena, Arthur J Kaffes
BACKGROUND AND AIM: Endoscopic retrograde cholangiopancreatography (ERCP) in patients with roux-en-Y anastomosis (REYA) is challenging. Use of double balloon enteroscope-assisted ERCP (DBE-ERCP) has been successful. We aim to determine predictors of successful biliary cannulation with DBE-ERCP in patients with REYA. METHODS: We retrospectively studied patients with REYA who had DBE-ERCP between 2009 and 2015. RESULTS: 86 DBE-ERCP were done on 52 patients...
September 17, 2016: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
Radan Keil
UNLABELLED: Pancreatitis of biliary etiology accounts for 30-60 % of all cases of acute pancreatitis. A number of randomized studies have been completed to assess the role of acute endoscopic retrograde cholangiopancreatography (ERCP) and papilosphincterotomy in the therapy of biliary pancreatitis. Analysis of the respective studies has shown that urgent endoscopy is clearly indicated for the patients with a severe form of acute biliary pancreatitis as well as for those with an ongoing acute cholangitis or obstructive icterus...
2016: Vnitr̆ní Lékar̆ství
Simon Richards, Stephen Kyle, Campbell White, Falah El-Haddawi, Glenn Farrant, Nigel Henderson, Michael Fancourt, William Gilkison
BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) is an essential tool in the management of pancreaticobiliary pathology. It is technically demanding and has the potential to cause significant morbidity and mortality. Several trials have identified small centres and lower hospital volume as risk factors for lower success rates and higher complication rates. Taranaki Base Hospital (TBH) is a provincial hospital with a catchment of 100 000, providing its population with an on-site ERCP service...
September 6, 2016: ANZ Journal of Surgery
Thibaut Vaysse, Isabelle Boytchev, Guillemette Antoni, Damien Sainte Croix, André Daniel Choury, Valérie Laurent, Gilles Pelletier, Catherine Buffet, Rita Bou-Farah, Franck Carbonnel
INTRODUCTION: There is still uncertainty regarding the efficacy and optimal modalities of extracorporeal shock wave lithotripsy (ESWL) in the treatment of chronic pancreatitis. The aims of the present study were to assess the safety and the efficacy of ESWL, either alone or followed by therapeutic endoscopic retrograde cholangiopancreatography (adjuvant ERCP) and to determine predictive factors of efficacy, in a real-life setting. PATIENTS AND METHODS: This study included all consecutive patients who underwent an ESWL in a single University Hospital between 2001 and 2012...
November 2016: Scandinavian Journal of Gastroenterology
Mika Ukkonen, Antti Siiki, Anne Antila, Tuula Tyrväinen, Juhani Sand, Johanna Laukkarinen
BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) is a frequent procedure in elderly patients. AIMS: We aimed to determine the safety and efficacy of acute ERCP in older patients. METHODS: A prospectively managed, hospital-based registry containing all ERCP procedures and complications at a tertiary referral center was used to form the study population, which consisted of consecutive elderly (≥65 years) patients undergoing acute ERCP during the 5-year study period...
November 2016: Digestive Diseases and Sciences
Michael W Wandling, Eric S Hungness, Emily S Pavey, Jonah J Stulberg, Ben Schwab, Anthony D Yang, Michael B Shapiro, Karl Y Bilimoria, Clifford Y Ko, Avery B Nathens
Importance: There are currently 2 widely accepted treatment strategies for patients presenting to the hospital with choledocholithiasis. However, the rate of use for each strategy in the United States has not been evaluated, and their trends over time have not been described. Furthermore, an optimal management strategy for choledocholithiasis has yet to be defined. Objective: To evaluate secular trends in the management of choledocholithiasis in the United States and to compare hospital length of stay between patients with choledocholithiasis treated with endoscopic retrograde cholangiopancreatography with laparoscopic cholecystectomy (ERCP+LC) vs laparoscopic common bile duct exploration with laparoscopic cholecystectomy (LCBDE+LC)...
August 24, 2016: JAMA Surgery
Ji Young Bang, Udayakumar Navaneethan, Muhammad K Hasan, Robert H Hawes, Shyam Varadarajulu
BACKGROUND AND STUDY AIMS: Although the diagnostic features of disconnected pancreatic duct syndrome (DPDS) by computed tomography (CT) and magnetic/endoscopic retrograde cholangiopancreatography (MRCP/ERCP) have been established, no such characterization exists for endoscopic ultrasound (EUS). This study describes the imaging features of EUS that accurately define DPDS. PATIENTS AND METHODS: This is a prospective study comprising 21 of 42 patients who underwent EUS-guided drainage of walled-off necrosis (WON) over an 18-month period...
August 2016: Endoscopy International Open
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), endoscopic retrograde cholangiopancreatography (ERCP)...
August 6, 2016: Journal of Pediatric Gastroenterology and Nutrition
K Leslie, M L Allen, E Hessian, A Y-S Lee
We conducted a survey of Australian specialist anaesthetists about their practice of sedation for elective and emergency gastroscopy, endoscopic retrograde cholangiopancreatography (ERCP), and colonoscopy. A 24-item survey was emailed to 1,000 anaesthetists in August 2015. Responses were received from 409 anaesthetists (response rate=41%) with responses from 395 anaesthetists analysed. Pulse oximetry and oxygen administration were routine for all procedures for all respondents. Blood pressure was routinely measured by most respondents during gastroscopy (elective=88%; emergency=97%), ERCP (elective=99%; emergency=99%) and colonoscopy (elective=91%; emergency=98%)...
July 2016: Anaesthesia and Intensive Care
Alastair Dorreen, Sarvee Moosavi, Myriam Martel, Alan N Barkun
Background. The safety of endoscopy after an acute coronary syndrome (ACS) is poorly characterized. We thus performed a systematic review assessing the safety of endoscopy following ACS. Methods. Searches in EMBASE, Medline, and Web of Science identified articles for inclusion. Data abstraction was completed by two independent reviewers. Results. Fourteen retrospective studies yielded 1178 patients (mean 71.3 years, 59.0% male) having suffered an ACS before endoscopy. Patients underwent 1188 endoscopies primarily to investigate suspected gastrointestinal bleeding (81...
2016: Canadian Journal of Gastroenterology & Hepatology
Yimin Dong, Hitendra Patel, Charmi Patel
Intrabiliary metastasis from colorectal carcinoma (CRC) growing within or invading bile ducts is not a very common pattern. However, accurate diagnosis of metastatic lesions is very important for selection of adjuvant therapy and prognosis. We report a case of 71-year-old male who developed painless jaundice due to hepatobiliary obstruction. MRI demonstrated 1.4 cm intraductal mass at hepatic hilum with severe intrahepatic ductal dilation, consistent with cholangiocarcinoma. ERCP (endoscopic retrograde cholangiopancreatography) showed intraductal segmental biliary stricture...
2016: Case Reports in Pathology
Matthew E Feurer, Peter V Draganov
Advanced endoscopy has evolved from diagnostic ERCP to an ever-increasing array of therapeutic procedures including EUS with FNA, ablative therapies, deep enteroscopy, luminal stenting, endoscopic suturing and endoscopic mucosal resection among others. As these procedures have become increasingly more complex, the risk of potential complications has also risen. Training in advanced endoscopy involves more than obtaining a minimum number of therapeutic procedures. The means of assessing a trainee's competence level and ability to practice independently continues to be a matter of debate...
June 2016: Best Practice & Research. Clinical Gastroenterology
Jun-Ho Choi, Hong Ja Kim, Byung Uk Lee, Tae Hyeon Kim, Il Han Song
BACKGROUND & AIMS: Vigorous intravenous fluid resuscitation (IVFR) was reported to reduce post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis in a pilot study. We performed a randomized, double-blind controlled trial to establish whether periprocedural vigorous IVFR reduces the risk of post-ERCP pancreatitis. METHODS: A total of 510 patients with native papilla at 3 tertiary referral centers in Korea were randomly assigned (1:1) to groups given vigorous IVFR (lactated Ringer's solution in an initial bolus of 10 mL/kg before the procedure, 3 mL/kg/h during the procedure, for 8 hours after the procedure, and a post-procedure bolus of 10 mL/kg) or a standard IVFR (lactated Ringer's solution at 1...
June 14, 2016: Clinical Gastroenterology and Hepatology
Wei Peng, Liang Wang, Xuhui Qiu, Yiping Jiang, Ting Han, Lan Pan, Xiaoguang Jia, Luping Qin, Chengjian Zheng
ETHNOPHARMACOLOGICAL RELEVANCE: Caragana pruinosa Kom. is a deciduous shrub belonging to the genus of Caragana (Leguminosae), and Caragana plants exhibit a wide range of interesting pharmacological properties including anti-inflammatory, analgesic, and anti-arthritis activity, etc. AIM OF THE STUDY: This study was aimed to investigate the anti-arthritic effect of 80% EtOH extract from the roots of C. pruinosa (ERCP) on arthritis and explore the potential pharmacological mechanism...
September 15, 2016: Journal of Ethnopharmacology
Karen Hartery, Chung Sen Lee, Glen A Doherty, Frank E Murray, Garret Cullen, Stephen E Patchett, Hugh E Mulcahy
BACKGROUND AND AIMS: Little medical literature exists for the use of fully covered self-expanding metal stents (CSEMSs) in the management of retained common bile duct (CBD) stones. Our aim was to assess the safety and efficacy of CSEMSs for the indication of retained "difficult" CBD stones. METHODS: This retrospective cases series included 44 patients (30 women; median age, 69 years [range, 24-88]) who underwent CSEMS insertion for the indication of retained "difficult" CBD stones in 2 tertiary referral centers...
June 1, 2016: Gastrointestinal Endoscopy
Shafqat Mehmood, Asif Loya, Muhammed Aasim Yusuf
PURPOSE: To evaluate the diagnostic yield of biliary brush cytology and the factors affecting positive results in patients with biliary strictures. PATIENTS AND METHODS: The medical records of all patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) with biliary brush cytology at our institution from November 2004 to December 2013 were reviewed in this retrospective study. The yield of positive brush cytology and the factors affecting positive yield, such as stricture location, age, gender and preprocedure CA 19...
2016: Acta Cytologica
K R Yusif-Zadeh, B K Agaev
THE PURPOSE OF THE STUDY: optimization measures for postoperative management of patients after laparoscopic cholecystectomy. MATERIAL AND METHODS: In the study group included 102 women and 302 men. At the 303 patients (75%) for specific indications ERCP was performed. Age of patients varied from 16 to 80 years and averaged 47.7 ± 12.9 years. It should be noted that at 298 (98.3%) patients ERCP was performed prior to laparoscopic cholecystectomy with diagnostic or therapeutic purposes...
2015: Experimental & Clinical Gastroenterology
Oleg Shulik, Yana Cavanagh, Matthew Grossman
BACKGROUND: Pancreatic abscesses are rare. They may be seen in patients with pancreatic inflammation or pancreatitis. Patients with pancreatic abscesses may have abdominal pain, fever, chills, and nausea/vomiting or an inability to eat. Presentation with alternate symptomatology is extremely unusual. CASE REPORT: A 67-year-old Asian male presented with painless, afebrile obstructive jaundice and a CA 19-9 of 1732 IU. He was found to have a 3.1×2.4 cm low-density lesion in the head of the pancreas and the right lobe of the liver, suggesting malignancy...
2016: American Journal of Case Reports
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