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Pancreatitis after ERCP

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https://www.readbyqxmd.com/read/29320523/risk-of-pancreatitis-after-pancreatic-duct-guidewire-placement-during-endoscopic-retrograde-cholangiopancreatography
#1
Yuki Ishikawa-Kakiya, Masatsugu Shiba, Hirotsugu Maruyama, Kunihiro Kato, Shusei Fukunaga, Satoshi Sugimori, Koji Otani, Shuhei Hosomi, Fumio Tanaka, Yasuaki Nagami, Koichi Taira, Hirokazu Yamagami, Tetsuya Tanigawa, Toshio Watanabe, Yasuhiro Fujiwara
BACKGROUND & AIMS: Advanced techniques have been developed to overcome difficult cannulation cases in endoscopic retrograde cholangiopancreatography (ERCP). Pancreatic duct guidewire placement method (PGW) is performed in difficult cannulation cases; it is possible that it places patients at risk of post-ERCP pancreatitis (PEP). The mechanism of PEP is still unclear, but pancreatic duct pressure and injury of pancreatic duct are known causes of PEP. Therefore, we hypothesized a relationship between pancreatic duct diameter and PEP and predicted that PGW would increase the risk of PEP in patients with non-dilated pancreatic ducts...
2018: PloS One
https://www.readbyqxmd.com/read/29237204/aggressive-intravenous-hydration-with-lactated-ringer-s-solution-for-prevention-of-post-ercp-pancreatitis-a-prospective-randomized-multicenter-clinical-trial
#2
Chang-Hwan Park, Woo Hyun Paik, Eun Taek Park, Chan Sup Shim, Tae Yoon Lee, Changdon Kang, Myung Hwan Noh, Sun Youn Yi, Jong Kyun Lee, Jong Jin Hyun, Jun Kyu Lee
Background and study aims The present study aimed to determine the type of intravenous hydration that is best suited to reducing the incidence of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis. Patients and methods In a prospective randomized multicenter trial, average-to-high risk patients who underwent first-time ERCP were randomly assigned to three groups (1:1:1) who received: aggressive intravenous hydration (3 mL/kg/h during ERCP, a 20-mL/kg bolus and 3 mL/kg/h for 8 hours after ERCP) with either lactated Ringer's solution (LRS) or normal saline solution (NSS), or standard intravenous hydration with LRS (1...
December 13, 2017: Endoscopy
https://www.readbyqxmd.com/read/29228432/analysis-of-risk-factors-and-prevention-strategies-of-post-ercp-pancreatitis
#3
Y Lin, X Liu, D-Q Cao, J-H Tang, J-J Wen, T-F Li, P-F Liu, T-S Xia
OBJECTIVE: To analyze the relevant risk factors and preventive measures for post-endoscopic retrograde cholangiopancreatography (post-ERCP) pancreatitis (PEP) so as to improve the diagnosis and treatment levels of ERCP, thus reducing the prevalence rate of PEP. PATIENTS AND METHODS: The clinical data of 278 patients receiving ERCP from January 2014 to December 2016 were retrospectively analyzed. First, the univariate analysis was conducted for the factors such as gender, age, diameter of common bile duct, whether development occurred in the pancreatic duct and other factors...
November 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29225082/comparison-of-eus-with-magnetic-resonance-cholangiopancreatography-in-idiopathic-acute-pancreatitis-a-systematic-review-and-meta-analysis
#4
REVIEW
Jianhua Wan, Yaobin Ouyang, Chen Yu, Xiaoyu Yang, Liang Xia, Nonghua Lu
BACKGROUND: /Aims: Idiopathic acute pancreatitis (IAP) poses a diagnostic challenge for gastroenterologists, as confirmation of the disease etiology has important implications for the selection of the best possible treatment and the prevention of possible recurrence or the development of chronic pancreatitis. ERCP, EUS, and magnetic resonance cholangiopancreatography (MRCP) are typically used to diagnose IAP when conventional radiological methods fail. However, their exact role in the diagnosis of IAP has not yet been determined...
December 7, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29201486/gallstone-pancreatitis-a-common-but-often-overlooked-cause-of-abdominal-pain-in-post-liver-transplant-patients
#5
Napatt Kanjanahattakij, Kamolyut Lapumnuaypol, Sanna Fatima, Eyob Feyssa
Introduction: In general population, gallstone pancreatitis is the most common cause of pancreatitis. However, there are very few literatures that address this topic in post-liver-transplant patients. Clinical Case: A 69-year-old female who had a liver transplant in 2015 due to hepatocellular carcinoma and nonalcoholic steatohepatitis (NASH) cirrhosis. She had a recent episode of acute cellular rejection that was treated with high dose methylprednisolone 1 week prior to admission...
2017: Case Reports in Transplantation
https://www.readbyqxmd.com/read/29188552/intrahepatic-subcapsular-biloma-after-endoscopic-retrograde-cholangiopancreatography-treated-by-endoscopic-biliary-drainage
#6
Hiroaki Igarashi, Hiroko Yamashita, Kiyoshi Tsuchiya, Dai Sugimoto, Itsuro Ogata
Several major complications from endoscopic retrograde cholangiopancreatography (ERCP), including pancreatitis, cholangitis, and hemorrhage have been discussed in detail; however, a few uncommon but severe complications have been reported. We encountered an unusual case of post-ERCP intrahepatic subcapsular biloma. An 89-year-old woman with a 25-mm mass located at the hepatic hilum, suggestive of cholangiocarcinoma, underwent ERCP which demonstrated complete stricture of the common hepatic duct. Subsequently, two plastic stents were placed from the common bile duct to the right and left intrahepatic branches...
November 29, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/29161794/feasibility-of-temporary-pancreatic-stenting-after-early-endoscopic-retrograde-cholangiopancreatography-in-patients-with-acute-biliary-pancreatitis
#7
Jun Kyu Lee, Dong Kee Jang, Hyun Woo Kang, Sang Hyub Lee
Background/Aims: To assess the safety and effectiveness of temporary pancreatic stenting after early endoscopic retrograde cholangiopancreatography (ERCP) in patients with acute biliary pancreatitis regardless of the severity or concomitant cholangitis. Methods: Temporary pancreatic stenting was performed in 79 patients with visualized pancreatic duct during ERCP. The outcomes of 64 patients with adequate pancreatic stenting (PS) and 15 patients with inadequate pancreatic stenting (no PS) were compared in this prospective, observational trial...
November 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/29154236/risk-factors-of-pancreatitis-after-endoscopic-sphincterotomy-review-of-literature-and-practical-remarks-based-on-approximately-10-000-ercps
#8
REVIEW
Andrzej Jamry
Post-endoscopic pancreatitis (PEP) is the most common complication of endoscopic retrograde cholangiopancreatography (ERCP). Depending on the presence of risk factors, PEP can occur in 4,1% to about 43% of patients. According to the European Society of Gastrointestinal Endoscopy (ESGE) guidelines, only three to patient-associated risk factors have been identified: suspected sphincter of Oddi dysfunction (SOD) (OR 4.09), female gender (OR 2.23), and previous pancreatitis (OR 2.46). Another three procedure-associated factors include cannulation attempt duration > 10 minutes (OR 1...
October 31, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/29145338/pancreatogenic-choledocholithiasis-in-common-bile-duct-stump-after-roux-en-y-hepaticojejunostomy-a-case-report
#9
Yuan-Hui Jiang, An-Hong Zhang, Shao-Jun Zhou
RATIONALE: Choledocholithiasis in common bile duct (CBD) stump after Roux-en-Y hepaticojejunostomy (RYHJ) is incredibly rare and its pathophysiology is poorly understood. PATIENT CONCERNS: A 79-year-old woman was admitted to our hospital with upper abdominal pain radiating through to the back in November 2016. DIAGNOSES: Abdominal computed tomography (CT) scan and magnetic resonance cholangiopancreatography (MRCP) revealed filling defects in CBD stump, chronic pancreatitis, and dilatation of CBD stump and main pancreatic duct (MPD)...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29124124/preliminary-experience-with-pancreatic-sphincterotomy-as-treatment-for-intraductal-papillary-mucinous-neoplasm-associated-recurrent-pancreatitis
#10
Laura Bernardoni, Stefano Francesco Crinò, Giorgia De Conti, Maria Cristina Conti Bellocchi, Nicolò De Pretis, Antonio Amodio, Luca Frulloni, Armando Gabbrielli
Background and study aims:  Pancreatic intraductal papillary mucinous neoplasms (IPMN) are cystic tumors of the pancreas characterized by a malignant potential. IPMN have been associated with recurrent pancreatitis (RP). Obstruction of the main pancreatic duct by thick mucus has been postulated to be the cause of pancreatitis. In a few isolated reports, pancreatic sphincterotomy (PS) has been reported to reduce the frequency of pancreatitis. The aim of this study was to assess the efficacy of PS in patients with IPMN-associated RP...
November 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/29118690/pneumoperitoneum-after-endoscopic-retrograde-cholangiopancreatography-due-to-rupture-of-intrahepatic-bile-ducts-and-glisson-s-capsule-in-hepatic-metastasis-a-case-report-and-review-of-literature
#11
Zubair Khan, Umar Darr, Mohamad Nawras, Muhammad Bawany, Jacob Bieszczad, Osama Alaradi, Ali Nawras
Introduction: Endoscopic retrograde cholangiopancreatography (ERCP) has been proven to be a safe and effective method for diagnosis and treatment of biliary and pancreatic disorders. Major complications of ERCP include pancreatitis, hemorrhage, cholangitis, and duodenal perforation. We report a third case in literature of pneumoperitoneum after ERCP due to rupture of intrahepatic bile ducts and Glisson's capsule in a peripheral hepatic lesion. Case Report: A 50-year-old male with a history of metastatic pancreatic neuroendocrine tumor and who had a partially covered metallic stent placed in the biliary tree 1 year ago presented to the oncology clinic with fatigue, abdominal pain, and hypotension...
September 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29099022/efficacy-of-pancreatic-endotherapy-in-pancreatic-ascites-and-pleural-effusion
#12
Sudhir Gupta, Nitin Gaikwad, Amol Samarth, Niraj Sawalakhe, Tushar Sankalecha
Pancreatic ascites and effusion is a challenging complication to manage, hence our aim was to evaluate the efficacy of pancreatic endotherapy in pancreatic ascites and pleural effusion. Endotherapy included endoscopic retrograde cholangiopancreatography (ERCP) with a pancreatogram and pancreatic stent placement across the leak in patients with pancreatic ascites/effusion. A total of 53 patients were included after successful cannulation. The male:female ratio was 7.8:1. The pancreatogram revealed a leak from the pancreatic duct in 20/53 (37...
March 27, 2017: Medical Sciences: Open Access Journal
https://www.readbyqxmd.com/read/29093393/retroperitoneal-perforation-caused-by-migration-of-a-pancreatic-spontaneous-dislodgement-stent-into-periampullary-diverticula
#13
Masatake Nishiwaki, Chiemi Mizuno, Kota Yano, Hirohisa Oya, Ichiro Amano, Junko Matsumoto, Izumi Tanaka, Naoki Sawai, Masayuki Mizuno, Toshihide Shima, Yoshiharu Miyamoto, Takeshi Okanoue
An 85-year-old woman underwent endoscopic retrograde cholangiopancreatography (ERCP) for obstructive jaundice. Selective bile duct cannulation was unsuccessful because of periampullary diverticula (PAD). A pancreatic spontaneous dislodgement stent (PSDS) (5F diameter, 3 cm, straight type) was inserted to prevent post-ERCP pancreatitis. Three days after ERCP, she complained of abdominal pain, and computed tomography revealed retroperitoneal perforation because of PSDS migration to the PAD. If the papillary orifice is observed at the diverticular rim or in the diverticula, a pigtailed PSDS on the duodenal side or flanged stent on the pancreatic ductal side should be inserted in order to prevent this rare adverse event...
November 1, 2017: Internal Medicine
https://www.readbyqxmd.com/read/29090241/multicenter-retrospective-and-comparative-study-of-5-minute-versus-15-second-endoscopic-papillary-balloon-dilation-for-removal-of-bile-duct-stones
#14
Ryunosuke Hakuta, Tsuyoshi Hamada, Yousuke Nakai, Hiroyuki Isayama, Hirofumi Kogure, Suguru Mizuno, Takahara Naminatsu, Hiroshi Yagioka, Osamu Togawa, Saburo Matsubara, Yukiko Ito, Natsuyo Yamamoto, Takeshi Tsujino, Kazuhiko Koike
BACKGROUND AND STUDY AIMS:  Endoscopic papillary balloon dilation (EPBD) is a method of bile duct stone removal that has a better long-term outcome but a high risk of post-ERCP pancreatitis (PEP). Recent studies have suggested that 5-minute EPBD can reduce the incidence of PEP. This study aimed to examine the safety and effectiveness of longer duration EPBD compared with shorter duration EPBD (5 minutes vs. 15 seconds after disappearance of the waist of a dilation catheter). PATIENTS AND METHODS:  Patients without a history of endoscopic sphincterotomy or EPBD who underwent EPBD to remove bile duct stones were selected retrospectively from five centers...
November 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/29062479/murine-genotype-impacts-pancreatitis-severity-and-systemic-inflammation-an-experimental-study
#15
Gabriel J Seifert, Karoline C Sander, Sabine Richter, Uwe A Wittel
BACKGROUND: Little is known regarding the impact of host response in acute pancreatitis. Here, we induce murine necrotizing pancreatitis in 9 different mouse strains. MATERIALS AND METHODS: We examined 9 different mouse strains: Balb/CB4J, C3H/HEJ, NOD/SHILT, A/J, AKR/J, C57BI/6J, DBA/2J, FVB/NJ, 129S1/SvlmJ. 10 animals per strain were randomly allotted to two groups. Sterile necrotizing pancreatitis was induced by injection of taurocholate into the common bile duct...
December 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/29047328/the-modified-pancreatic-stent-system-for-prevention-of-post-ercp-pancreatitis-a-case-control-study
#16
Cheng Zhang, Yu-Long Yang, Yue-Feng Ma, Hong-Wei Zhang, Jing-Yi Li, Mei-Ju Lin, Li-Jun Shi, Chun-Chun Qi
BACKGROUND: Prophylactic pancreatic stents after endoscopic retrograde cholangiopancreatography (ERCP) can help prevent post-ERCP pancreatitis. However most of the pancreatic stents need to be removed by another ERCP. The aim of this observational study was to investigate the feasibility and effectiveness of the modified pancreatic stent system for prevention of post-ERCP pancreatitis. METHODS: From November 2013 to November 2015, a total of 230 patients who had prophylactic pancreatic stent placed for prevention of post-ERCP pancreatitis at a single institution were identified and stratified...
October 18, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/29043861/nasobiliary-drainage-can-reduce-the-incidence-of-post-ercp-pancreatitis-after-papillary-large-balloon-dilation-plus-endoscopic-biliary-sphincterotomy-a-randomized-controlled-trial
#17
Qiang Huang, Feng Shao, Chen Wang, Wei Qi, Lu Jun Qiu, Zheng Liu
BACKGROUND AND AIMS: Post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis can be reduced following endoscopic papillary balloon dilation with the placement of an endoscopic nasobiliary drainage (ENBD) catheter. The aim of this study was to determine whether the placement of an ENBD reduces the risk of post-ERCP pancreatitis following endoscopic papillary large balloon dilation together with endoscopic biliary sphincterotomy. METHODS: A total of 160 patients with bile duct stones were randomly assigned (1:1) to an ENBD group or no-ENBD group...
October 18, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/29040894/demystifying-endoscopic-retrograde-cholangiopancreatography-ercp-during-pregnancy
#18
REVIEW
Vítor Magno-Pereira, Pedro Moutinho-Ribeiro, Guilherme Macedo
BACKGROUND: For many years, ERCP was avoided in pregnancy given the concerns regarding the adverse effects that, with special focus on radiation, could occur in the developing fetus. However, the postponement or rejection of ERCP in pregnant women, may lead to a higher risk for mother and fetus, especially when the indication is unequivocal, namely cholangitis, biliary pancreatitis and symptomatic choledocholithiasis. SUMMARY AND KEY MESSAGES: This review aims to summarize the scarce literature on the subject in order to plan ERCP in pregnancy with the highest safety...
December 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29032692/a-post-endoscopic-retrograde-cholangiopancreatography-subcapsular-hepatic-hematoma
#19
Rocío Soler Humanes, Miguel Ángel Suárez Muñoz, Blanca García García
Nowadays endoscopic retrograde cholangiopancreatography (ERCP) is a minimally invasive technique with a complication rate around 2.5% in expert hands, being the most frequent: acute pancreatitis, cholangitis, hemorrhage and perforation. An exceptional complication is subcapsular hepatic hematoma, first published in the literature in 2000, with few cases reported. Regarding the case published by Del Moral Martínez et al (Hepatic Hematoma after ERCP: presentation of two new cases. Rev Esp Enferm Dig 2017, Vol...
November 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/29020689/transpancreatic-precut-papillotomy-versus-double-guidewire-technique-in-difficult-biliary-cannulation-prospective-randomized-study
#20
Harutoshi Sugiyama, Toshio Tsuyuguchi, Yuji Sakai, Rintaro Mikata, Shin Yasui, Yuto Watanabe, Dai Sakamoto, Masato Nakamura, Takao Nishikawa
BACKGROUND AND STUDY AIMS:  Difficult biliary cannulation and unintentional pancreatic duct cannulation are thought to be important contributors to pancreatitis occurring after endoscopic retrograde cholangiopancreatography. Our aim was to compare and evaluate the rates of success and complications of transpancreatic precut papillotomy (TPPP) and the double-guidewire technique (DGT), both with prophylactic pancreatic stenting. PATIENTS AND METHODS:  From April 2011 to March 2014, patients with difficult biliary cannulation, in whom we planned to first position a guidewire in the pancreatic duct, were enrolled, and 68 patients were prospectively randomly allocated to two groups (TPPP 34, DGT 34)...
January 2018: Endoscopy
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