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Pancreatitis after ERCP

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https://www.readbyqxmd.com/read/29145338/pancreatogenic-choledocholithiasis-in-common-bile-duct-stump-after-roux-en-y-hepaticojejunostomy-a-case-report
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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...
October 8, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29032692/a-post-endoscopic-retrograde-cholangiopancreatography-subcapsular-hepatic-hematoma
#11
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
#12
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)...
October 11, 2017: Endoscopy
https://www.readbyqxmd.com/read/28966682/prophylactic-ulinastatin-administration-for-preventing-post-endoscopic-retrograde-cholangiopancreatography-pancreatitis-a-meta-analysis
#13
Kun Zhu, Jian-Ping Wang, Jin-Gen Su
The objective of the present study was to perform a meta-analysis of all available studies on the effect of prophylactic ulinastatin administration on preventing post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP). The PubMed, Web of Knowledge and Chinese National Knowledge Infrastructure databases were searched to identify all relevant studies published in English or Chinese prior to April 2016. Cochrane Review Manager was used to calculate the pooled risk ratio (RR) and 95% confidence interval (CI) to determine the effect of prophylactic ulinastatin on PEP, post-ERCP hyperamylasemia (PEHA) and post-ERCP abdominal pain...
October 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28966569/efficacy-of-endotherapy-in-the-treatment-of-pain-associated-with-chronic-pancreatitis-a-systematic-review-and-meta-analysis
#14
Mikram Jafri, Amit Sachdev, Javed Sadiq, David Lee, Ting Taur, Adam Goodman, Frank Gress
BACKGROUND: Endotherapy is a treatment modality that can be used to manage the pain associated with chronic pancreatitis. The aim of this systematic review and meta-analysis is to evaluate the efficacy of endotherapy in the management of pain associated with chronic pancreatitis. METHODS: A search of Medline, Pubmed, and Embase databases between 1988 to December 2014 was conducted to evaluate the use of endotherapy for pain relief in patients with chronic pancreatitis...
March 2017: JOP: Journal of the Pancreas
https://www.readbyqxmd.com/read/28964747/safety-and-efficacy-of-early-feeding-based-on-clinical-assessment%C3%A2-at-4-hours-after-ercp-a-prospective-randomized%C3%A2-controlled-trial
#15
Chan Hyuk Park, Jang Han Jung, Bomi Hyun, Hye Ji Kan, Jin Lee, Sea Hyub Kae, Hyun Joo Jang, Dong Hee Koh, Min Ho Choi, Moon Jae Chung, Seungmin Bang, Se Woo Park
BACKGROUND AND AIMS: The optimal timing of refeeding after ERCP is unknown. Some practices keep the patient fasting for 24 hours after ERCP, whereas others resume feeding earlier. We aimed to evaluate the risk of post-ERCP pancreatitis (PEP) in patients who initiate early feeding, based on their clinical assessment, including serum amylase testing performed at 4 hours after ERCP. METHODS: Patients who were scheduled for ERCP were recruited. Patients without abdominal pain and tenderness and a serum amylase level within 1...
September 28, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28960034/prediction-of-post-endoscopic-retrograde-cholangiopancreatography-pancreatitis-using-4-hour-post-endoscopic-retrograde-cholangiopancreatography-serum-amylase-and-lipase-levels
#16
Yeon Kyung Lee, Min Jae Yang, Soon Sun Kim, Choong Kyun Noh, Hyo Jung Cho, Sun Gyo Lim, Jae Chul Hwang, Byung Moo Yoo, Jin Hong Kim
Early post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) prediction may allow safe same-day outpatients discharge after ERCP and earlier proper management. This study aimed to assess the usefulness of the 4-hour post-ERCP serum amylase and lipase levels for PEP early prediction and to investigate predictive cut-off values for 4-hour post-ERCP serum amylase and lipase levels for safe discharge and urgent initiation of resuscitation. The data of 516 consecutive patients with native papilla who underwent ERCP between January 2013 and August 2014 were retrospectively reviewed...
November 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28834874/common-bile-duct-stones-associated-with-pancreatobiliary-reflux-and-disproportionate-bile-duct-dilatation
#17
Cheal Wung Huh, Hee Wook Kim, Seung Woo Yi, Dong Ki Lee, Se Joon Lee
Occult pancreatobiliary reflux (PBR) in patients with a normal pancreatobiliary junction has been studied by various methods, but the exact etiology, mechanisms, and implications of this reflux have not yet been clarified. The aim of this study was to investigate the degree of PBR and patterns of biliary ductal dilatation in patients with acute calculous cholangitis by endoscopic retrograde cholangiopancreatography (ERCP).We retrospectively evaluated the degree of PBR and pattern of bile duct dilatation in patients with acute calculous cholangitis due to distal CBD (common bile duct) stones (Group A) as compared with patients with malignant CBD obstruction due to distal CBD cancer (Group B)...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28752146/acute-biliary-pancreatitis-in-cholecystectomised-patients
#18
Fatih Ciftci, Turgut Anuk
OBJECTIVE: The present study is an evaluation of cases of acute biliary pancreatitis that developed subsequent to cholecystectomy. METHODS: Total of 44 patients were assessed in this retrospective study. Demographic characteristics, severity of illness, time elapsed between cholecystectomy and development of pancreatitis, whether endoscopic sphincterotomy (ES) was performed, surgical procedure used, duration of hospitalization, and mortality data were recorded. RESULTS: Mean age of all patients was 60...
2017: Northern Clinics of Istanbul
https://www.readbyqxmd.com/read/28713597/ketamine-use-for-successful-resolution-of-post-ercp-acute-pancreatitis-abdominal-pain
#19
Suneel M Agerwala, Divya Sundarapandiyan, Garret Weber
We report a case in which a patient with intractable pain secondary to post-endoscopic retrograde cholangiopancreatography (ERCP) acute pancreatitis is successfully treated with a subanesthetic ketamine infusion. Shortly after ERCP, the patient reported severe stabbing epigastric pain. She exhibited voluntary guarding and tenderness without distension. Amylase and lipase levels were elevated. Pain persisted for hours despite hydromorphone PCA, hydromorphone boluses, fentanyl boluses, and postprocedure anxiolytics...
2017: Case Reports in Anesthesiology
https://www.readbyqxmd.com/read/28712198/pancreatic-duct-stones
#20
Mohammad Naeem Khan, Syed Shahmeer Raza, Amer Kamal Hussain, Muhammad Daniyal Nadeem, Farhan Ullah
pancreatitis appears to exist in the presence of such calculi upon radiology. Having said that, pancreatic ductal stone due to biliary causes (origin), in face of acute pancreatitis, is rare. To the best of our knowledge this was the first case of its kind presented to our hospital in recent past. A 25-year-old female presented to the emergency department of our hospital with an acute episode of pancreatitis. Computerized tomography (CT) scan, endoscopic retrograde cholangiopancreatography (ERCP) & magnetic resonance cholangiopancreatography (MRCP) concluded acute pancreatitis (AP) with dilated main pancreatic duct left side branches and intra ductal calculi...
January 2017: Journal of Ayub Medical College, Abbottabad: JAMC
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