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Pancreatitis after ERCP

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https://www.readbyqxmd.com/read/28391672/endoscopic-ultrasound-guided-pancreatic-duct-intervention
#1
REVIEW
Yuto Shimamura, Jeffrey Mosko, Christopher Teshima, Gary R May
Endoscopic ultrasound-guided pancreatic duct intervention (EUS-PDI) is an emerging endoscopic approach allowing access and intervention to the pancreatic duct (PD) for patients with failed endoscopic retrograde pancreatography (ERP) or patients with surgically altered anatomy. As opposed to biliary drainage for which percutaneous drainage is an alternative following failed endoscopic retrograde cholangiopancreatography (ERCP), the treatment options after failed ERP are very limited. Therefore, endoscopic ultrasound (EUS)-guided access to the PD and options for subsequent drainage may play an important role as an alternative to surgical intervention...
March 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/28385584/a-study-of-the-clinical-utility-of-a-20-minute-secretin-stimulated-endoscopic-pancreas-function-test-and-performance-according-to-clinical-variables
#2
Luis F Lara, Morihito Takita, James S Burdick, Daniel C DeMarco, Ronnie R Pimentel, Tolga Erim, Marlon F Levy
BACKGROUND & AIMS: Direct pancreas juice testing of bicarbonate, lipase, or trypsin after stimulation by secretin or cholecystokinin (CCK) is used to determine exocrine function, a surrogate for diagnosing chronic pancreatitis (CP). Endoscopic pancreas function tests (ePFT) where a peak bicarbonate concentration (PBC) ≥80 mEq/L in pancreas juice is considered normal are now used more frequently. In this ePFT aspirates start 35 minutes after secretin administration because pancreas output peaks 30 minutes after secretagogue administration...
April 3, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28374181/diclofenac-does-not-reduce-the-risk-of-post-endoscopic-retrograde-cholangiopancreatography-pancreatitis-in-low-risk-units
#3
Mia Rainio, Outi Lindström, Marianne Udd, Johanna Louhimo, Leena Kylänpää
BACKGROUND: Nonsteroidal anti-inflammatory drugs have an inhibitory role in pathogenesis of pancreatitis. Guidelines from the European Society of Gastrointestinal Endoscopy recommend routine rectal administration of 100 mg of diclofenac or indomethacin immediately before or after ERCP for all patients without contraindications. AIMS: Our aim was to evaluate the effect of diclofenac in preventing post-ERCP pancreatitis (PEP) in a high-volume, low-PEP-risk ERCP unit...
April 3, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28364277/pediatric-choledochal-cysts-diagnosis-and-current-management
#4
REVIEW
Kevin C Soares, Seth D Goldstein, Mounes A Ghaseb, Ihab Kamel, David J Hackam, Timothy M Pawlik
Choledochal cysts are rare congenital disorders first described by Vater and Ezler in 1723. Their exact etiology remains incompletely understood; however, an anomalous pancreaticobiliary union (APBDU) and subsequent reflux of biliary contents into the biliary tree are thought to play a role. Accordingly, APBDU-associated choledochal cyst patients are significantly more likely to have evidence of hepatitis, cholangitis or pancreatitis and pathologically confirmed inflammation. In 1977, Todani and colleagues modified the original Alonso-Lej classification to include five types of CC...
March 31, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28355667/pancreas-divisum-in-children-and-duodenum-preserving-resection-of-the-pancreatic-head
#5
Jiri Snajdauf, Ondrej Petru, Jiri Nahlovsky, Michal Rygl, Barbora Frybova, Jiri Bronsky, Vladimir Mixa, Radan Keil
Introduction A retrospective study was performed to evaluate the clinical features, diagnostic methods, and treatment alternatives in children with pancreas divisum (PD). Materials and Methods Patients who underwent treatment for PD between 1999 and 2014 at our department were evaluated for sex, age, presenting symptoms, physical examination findings, biochemical markers, diagnostic methods, treatment modalities, and results of treatment during follow-up. Results Seven patients who underwent treatment of symptomatic PD were included in the study...
March 29, 2017: European Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28321347/association-of-chronic-pancreatitis-and-malignant-main-duct-ipmn-a-rare-but-difficult-clinical-problem
#6
Zoltán Berger, Hernán De La Fuente, Manuel Meneses, Fernanda Matamala, Makarena Sepúlveda, Claudia Rojas
We report the case of a 70-year-old woman who consulted for recurrent short episodes of mild-to-moderate abdominal pain. Dilated main pancreatic duct was seen on CAT scan and magnetic resonance, with multiple calcifications and intraductal stones, typical in CP. However, for a more pronounced cystic dilatation in the pancreatic head, we could not exclude the coexistence of a main duct IPMN. ERCP was performed, with pancreatic sphincterotomy and extraction of pancreatic stones, but, at the same time, mucin extrusion was seen from the dilated duct through the papilla...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/28315036/diagnosing-chronic-pancreatitis
#7
REVIEW
Ahmad Anaizi, Phil A Hart, Darwin L Conwell
Diagnosing CP can range from routine in those with severe disease and obvious calcifications on CT imaging to elusive in those patients with early changes in CP. The workup of suspected CP should follow a progressively noninvasive to more invasive STEP-wise approach in a patient with a suspicious clinical presentation and risk factors that raise their pretest probability of disease. After a thorough history and physical examination, basic laboratories should be obtained such as lipase, amylase, metabolic panel, and indirect PFTs (fecal elastase-1, serum trypsin)...
March 17, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28298192/how-to-select-patients-and-timing-for-rectal-indomethacin-to-prevent-post-ercp-pancreatitis-a-systematic-review-and-meta-analysis
#8
REVIEW
Jianhua Wan, Yuping Ren, Zhenhua Zhu, Liang Xia, Nonghua Lu
BACKGROUND: Acute pancreatitis is a severe complication of endoscopic retrograde cholangiopancreatography (ERCP). Previous meta-analyses have shown that indomethacin effectively prevents this complication; however, the data are limited. We performed a systematic review and meta-analysis to clarify the applications for rectal indomethacin. METHODS: A systematic search was performed in June 2016. Human prospective, randomized, placebo-controlled trials that compared rectally administered indomethacin with a placebo for the prevention of post-ERCP pancreatitis (PEP) were included...
March 15, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/28273606/an-impressive-choledochal-cyst-and-its-surgical-resection
#9
Nhu Thao Nguyen Galván, Kayla Kumm, Dor Yoeli, Ellen Witte, Michael Kueht, Ronald Timothy Cotton, Abbas Rana, Christine A O'Mahony, John A Goss
INTRODUCTION: Choledochal cysts are rare congenital dilations of the biliary tree that can present with non-specific symptoms such as abdominal pain, jaundice, cholelithiasis and pancreatitis. Although most commonly identified in children, they can be found in the adult population. However, because of the non-specific symptoms, this diagnosis may be difficult to make in the adult. A physician therefore must keep this diagnosis within their differential, as it may arise in an unexpected patient population who may present with a convoluted work up...
February 21, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28208000/two-cases-of-plug-or-stone-in-remnant-intrapancreatic-choledochal-cysts-treated-with-endoscopic-retrograde-cholangiopancreatography
#10
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/28207747/chronic-pancreatitis-multicentre-prospective-data-collection-and-analysis-by-the-hungarian-pancreatic-study-group
#11
Ákos Szücs, Tamás Marjai, Andrea Szentesi, Nelli Farkas, Andrea Párniczky, György Nagy, Balázs Kui, Tamás Takács, László Czakó, Zoltán Szepes, Balázs Csaba Németh, Áron Vincze, Gabriella Pár, Imre Szabó, Patrícia Sarlós, Anita Illés, Szilárd Gódi, Ferenc Izbéki, Judit Gervain, Adrienn Halász, Gyula Farkas, László Leindler, Dezső Kelemen, Róbert Papp, Richárd Szmola, Márta Varga, József Hamvas, János Novák, Barnabás Bod, Miklós Sahin-Tóth, Péter Hegyi
INTRODUCTION: Chronic pancreatitis is an inflammatory disease associated with structural and functional damage to the pancreas, causing pain, maldigestion and weight loss and thus worsening the quality of life. AIMS AND METHODS: Our aim was to find correlations from a multicentre database representing the epidemiological traits, diagnosis and treatment of the disease in Hungary. The Hungarian Pancreatic Study Group collected data prospectively from 2012 to 2014 on patients suffering from chronic pancreatitis...
2017: PloS One
https://www.readbyqxmd.com/read/28194668/value-of-raw-rhubarb-solution-in-the-precaution-of-post-endoscopic-retrograde-cholangiopancreatography-pancreatitis-in-patients-with-high-risk-factors-a-predictive-random-compared-research-in-one-center
#12
Chong Wang, Qirui Li, Peng Ye, Sheng Zeng, Guo-Hua Li, You-Xiang Chen, Xiao-Jiang Zhou, Nong-Hua Lv
BACKGROUND AND AIMS: Post-ERCP pancreatitis and hyperamylasemia are common complications of endoscopic retrograde cholangiopancreatography (ERCP), especially in high-risk patients. The aim of this study is to evaluate whether a raw rhubarb solution can reduce the incidence of PEP and post-ERCP hyperamylasemia. METHODS: From October 2012 to October 2013, 2100 patients received ERCP in our Endoscopic Center. Five hundred patients with high-risk factors were enrolled randomly into the raw rhubarb group (RG, 250 cases drank a raw rhubarb soak solution per 3 h until defecation after ERCP) and the control group (CG, 250 cases drank water after ERCP) in the study...
February 13, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28167118/indomethacin-and-diclofenac-in-the-prevention-of-post-ercp%C3%A2-pancreatitis-a-systematic-review-and-meta-analysis%C3%A2-of-prospective-controlled-trials
#13
REVIEW
Árpád Patai, Norbert Solymosi, László Mohácsi, Árpád V Patai
BACKGROUND AND AIMS: Diclofenac and indomethacin are the most studied drugs for preventing post-ERCP pancreatitis (PEP). However, there are no prospective, randomized multicenter trials with a sufficient number of patients for correct evaluation of their efficacy. Our aim was to evaluate all prospective trials published in full text that studied the efficacy of diclofenac or indomethacin and were controlled with placebo or non-treatment for the prevention of PEP in adult patients undergoing ERCP...
February 4, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28133066/-a-case-of-bismuth-iii-b-hilar-cholangiocarcinoma-resected-with-extended-left-hepatic-lobectomy-after-ercp-induced-pancreatitis
#14
Toru Mizutani, Hisashi Ikoma, Toshiyuki Kosuga, Hirotaka Konishi, Ryo Morimura, Yasutoshi Murayama, Shuhei Komatsu, Atsushi Shiozaki, Yoshiaki Kriu, Masayoshi Nakanishi, Daisuke Ichikawa, Hitoshi Fujiwara, Kazuma Okamoto, Toshiya Ochiai, Eigo Otsuji
Endoscopic retrograde cholangiopancreatography(ERCP)is widely accepted as the standard therapy before surgery for hilar cholangiocarcinoma. The patient is a 68-year-old man who presented with liver dysfunction. Computed tomography (CT)revealed abnormal lesions in his liver. He was referred to our hospital for therapy. We present a rare case of expansion of left lobectomy for Bismuth III b hilar cholangiocarcinoma after grade 2 severe pancreatitis caused by ERCP. He received arterial infusion therapy and endoscopic necrosectomy 6 times and percutaneous transhepatic biliary drainage(PTBD)...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28127713/optimal-timing-for-a-second-ercp-after-failure-of-initial-biliary-cannulation-following-precut-sphincterotomy-an-analysis-of-experience-at-two-tertiary-centers
#15
Juan Colan-Hernandez, Alexandra Aldana, Mar Concepción, Karina Chavez, Cristina Gómez, Angela Mendez-Bocanegra, Miguel Martínez-Guillen, Oriol Sendino, Càndid Villanueva, Josep Llach, Carlos Guarner-Argente, Andrés Cárdenas, Carlos Guarner
BACKGROUND AND STUDY AIMS: Precut sphincterotomy increases the success of deep biliary cannulation, but the method fails at the initial ERCP in 5-12% of cases. Although other invasive strategies are often used to access the bile duct, a second ERCP may be effective and safe. We evaluated the efficacy, safety, and factors related to a second ERCP after failed cannulation using a precut sphincterotomy. PATIENTS AND METHODS: We reviewed all patients that underwent an ERCP with native papilla from 2006 to 2014 at two tertiary institutions...
January 26, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28077962/the-influence-of-duodenally-delivered-shakuyakukanzoto-shao-yao-gan-cao-tang-on-duodenal-peristalsis-during-endoscopic-retrograde-cholangiopancreatography-a-randomised-controlled-trial
#16
Haruka Fujinami, Shinya Kajiura, Jun Nishikawa, Takayuki Ando, Toshiro Sugiyama
BACKGROUND: Anti-cholinergic agents may be used to inhibit duodenal peristalsis, but they may have adverse effects. Shakuyakukanzoto (Shao Yao Gan Cao Tang) has an anti-spasmodic effect and has been used before for oesophagogastroduodenoscopy and colonoscopy. This randomised clinical trial aimed to evaluate the inhibitory effect of Shakuyakukanzoto on duodenal peristalsis, and its usefulness when administered into the duodenum just before endoscopic retrograde cholangiopancreatography (ERCP)...
2017: Chinese Medicine
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
#17
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/28018225/role-of-somatostatin-in-preventing-post-endoscopic-retrograde-cholangiopancreatography-ercp-pancreatitis-an-update-meta-analysis
#18
REVIEW
Jing Hu, Pei-Lin Li, Tao Zhang, Jin-Ping Chen, Yao-Jun Hu, Zheng Yu, Jin-Peng Wang, Dan Zhu, Xiao-Fei Tong
Background: Acute pancreatitis is the most common serious complication of endoscopic retrograde cholangiopancreatography (ERCP). Although, somatostatin (SOM) has been used in the prevention of post-ERCP pancreatitis (PEP), the efficacy of SOM remains inconsistent. Methods: Electronic databases, including PubMed/MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library), and the Science Citation Index were searched to retrieve relevant studies. Details of the study population, including patients' characteristics, sample size, regimen of drug administration and incidence of PEP, hyperamylasemia and abdominal pain were extracted by two investigators...
2016: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/27998426/-value-of-integrated-pancreatic-and-biliary-stents-for-prevention-of-post-ercp-pancreatitis
#19
C Zhang, Y L Yang, Y Yu, C C Qi, M J Lin, L J Shi, H W Zhang, J Y Li, Y F Ma
Objective: To investigate the value of integrated pancreatic and biliary stents for prevention of post-Endoscopic Retrograde Cholangiopancreatography (ERCP) pancreatitis. Methods: The clinical data of patients whom had pancreatic stents for prevention of post-ERCP pancreatitis from December 2013 to October 2015 were retrospectively analyzed. The clinical effect and complication were compared between straight pancreatic stents group and integrated pancreatic and biliary stents group. Results: A total of 214 patients had pancreatic stents for prevention of post-ERCP pancreatitis...
December 13, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27957289/efficacy-of-endoscopic-ultrasonography-in-evaluation-of-undetermined-etiology-of-common-bile-duct-dilatation-on-abdominal-ultrasonography
#20
Rasoul Sotoudehmanesh, Naimeh Nejati, Maryam Farsinejad, Shadi Kolahdoozan
BACKGROUND The cause of common bile duct (CBD) dilatation cannot be determined by imaging modalities in many patients. The aim of this study was to assess the value of endoscopic ultrasonography (EUS) in detecting the cause of CBD dilatation in patients in whom ultrasonography could not demonstrate the cause of dilation. METHODS Prospectively, 152 consecutive patients who were referred for evaluation of dilated CBD (diameter ≥7 mm) of undetermined origin by ultrasonography were included in this study. All the patients underwent EUS...
October 2016: Middle East Journal of Digestive Diseases
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