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Pancreatitis after ERCP

Ivana Zitinic, Ivana Plavsic, Goran Poropat, Goran Hauser
Acute pancreatitis (AP) is a common gastrointestinal disease of varied etiology; however, the most common causes of AP are gallstones and alcohol abuse. AP has emerged as the most frequent complication after endoscopic retrograde cholangiopancreatography (ERCP). Post-ERCP pancreatitis is generally a clinically irrelevant condition; however, it can be severe or even fatal in up to 0.8% of cases. Different clinical courses and outcomes have been observed between mild and severe AP of different etiologies (i.e...
April 2018: Medical Hypotheses
Henggao Zhong, Xiaohong Wang, Lihua Yang, Lin Miao, Guozhong Ji, Zhining Fan
This study aimed to assess the clinical value of transprepancreatic septotomy indwelling guide wire or pancreatic duct stent in intractable endoscopic retrograde cholangiopancreatography (ERCP) for bile duct cannulation.Of the 2107 patients treated by ERCP, a total of 81 cases with difficult bile duct cannulation underwent transprebiliopancreatic septotomy (referred to as the septotomy group, 37 cases) and transprepancreatic septotomy with pancreatic duct stent (modified septotomy group, 44 cases). Success rates of cannulation and postoperative complications for both methods were compared...
January 2018: Medicine (Baltimore)
Vijeta Pamudurthy, Raju Z Abraham, Thomas Betlej, Ashish Shah, Dong Kim, Brian Sasso, Abraham Chacko
Background and study aims  Endoscopic retrograde cholangiopancreatography (ERCP) is an invasive diagnostic and interventional procedure used in conditions related to the pancreas and biliary tract. It has a complication rate ranging from 4 % to 10 %. Severe complications are few with the most common of them being post-ERCP pancreatitis, post-sphincterotomy bleeding, and perforation. A rare, but potentially life-threatening complication of ERCP is splenic injury. We report the case of a 60-year-old female with choledocholithiasis who sustained splenic decapsulation following ERCP...
March 2018: Endoscopy International Open
Ryoko Shimizuguchi, Masataka Kikuyama, Terumi Kamisawa, Sawako Kuruma, Kazuro Chiba
An 80-year-old woman with pancreatic cancer was admitted with fever and abdominal pain. Blood examinations showed an elevated CRP level. On computed tomography (CT), a pancreatic tumor with a dilated upstream main pancreatic duct (MPD) was seen. Endoscopic retrograde cholangiopancreatography (ERCP) showed the strictured part of the MPD at the head of the pancreas with upstream dilatation. A nasopancreatic drainage tube was placed. Through the tube, purulent pancreatic juice was discharged and culture of the pancreatic juice grew Klebsiella pneumoniae...
February 20, 2018: Clinical Journal of Gastroenterology
Diogo Turiani Hourneaux De Moura, Martin Coronel, Danielle Azevedo Chacon, Ryan Tanigawa, Dalton M Chaves, Sérgio E Matuguma, Marcos E Lera Dos Santos, José Jukemura, Eduardo Guimarâes Hourneaux De Moura
Pancreatic cancer is the second most common malignancy of the gastrointestinal tract in the US, and adenocarcinoma has been identified as the most common type of pancreatic cancer. Different types of pancreatic cancers have been classified: adenocarcinoma, ductal adenosquamous carcinoma, solid pseudopapillary tumors, endocrine neoplasms, acinar cell carcinoma, squamous cell carcinoma, cystic tumors, primary lymphoma of the pancreas, and metastatic lesions of the pancreas. Adenosquamous carcinoma is extremely rare, behave in a very aggressive way and is responsible for the 1 to 4% of the pancreatic exocrine neoplastic lesions...
October 2017: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
Eiji Funatsu, Atsuhiro Masuda, Mamoru Takenaka, Takashi Nakagawa, Hideyuki Shiomi, Hayato Yoshinaka, Takashi Kobayashi, Arata Sakai, Yosuke Yagi, Masaru Yoshida, Yoshifumi Arisaka, Yoshihiro Okabe, Hiromu Kutsumi, Takeshi Azuma
BACKGROUND: Previous pancreatitis is a definite patient-related risk factor for pancreatitis after endoscopic retrograde cholangiopancreatography (post-ERCP pancreatitis: PEP). However, the effects of differences in the history of PEP and acute pancreatitis on the occurrence of PEP have not been fully investigated. We examined the relationship between previous PEP or previous acute pancreatitis and procedural factors associated with PEP. METHODS: Clinical data on 1,334 consecutive patients undergoing ERCP between April 2006 and June 2010 were collected...
May 15, 2017: Kobe Journal of Medical Sciences
Hee Seung Lee, Moon Jae Chung, Jeong Youp Park, Seungmin Bang, Seung Woo Park, Si Young Song, Jae Bock Chung
Acute pancreatitis is a common diagnosis worldwide, with gallstone disease being the most prevalent cause (50%). The American College of Gastroenterology recommends urgent endoscopic retrograde cholangiopancreatography (ERCP) (within 24 h) for patients with biliary pancreatitis accompanied by cholangitis. Most international guidelines recommend that ERCP be performed within 72 h in patients with biliary pancreatitis and a bile duct obstruction without cholangitis, but the optimal timing for endoscopy is controversial...
2018: PloS One
Shuto Fujita, Hiroyoshi Matsukawa, Shigehiro Shiozaki, Daisuke Satoh, Hitoshi Idani, Yasutomo Ojima, Masao Harano, Kanyu Nakano, Daisuke Sumitani, Yasuhiro Choda, Michihiro Ishida, Soichiro Miyake, Tetsushi Kubota, Masazumi Okajima
Anaplastic carcinoma spindle cell type is an extremely rare disease and its prognosis is very poor. We herein report a case of anaplastic carcinoma spindle cell type of the pancreas. A 50-year-old man complaining of epigastralgia was found to have a pancreatic body-tail tumor by abdominal US and CT studies. Abdominal CT showed an irregular poorly-enhanced 33mm tumor containing a cystic component. ERCP revealed the main pancreatic duct was cut off at the tumor. Cytology of the pancreatic fluids did not indicate malignancy...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Takeshi Ishii, Noriaki Nakamura, Toshifumi Saitou, Kouji Yonekura, Yuichiro Watanabe, Takahiro Sanada, Hiroshi Kuwabara, Narihide Goseki, Morio Koike
We experienced a rare case of pancreatic neuroendocrine tumor(pNET)in which stenosis of the main pancreatic duct occurred despite the tumor diameter being less than 1 cm; therefore, here, we report this case with some literature review.A 41-year-old woman showed dilation of the main pancreatic duct on an abdominal ultrasound as part of a health examination, and she visited our department for a more detailed examination.Enhanced CT scan showed a 7mm subtle enhancing mass in the head of the pancreas and the upstream main pancreatic duct was dilated up to 7 mm...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Masashige Nishimura, Hiroshi Wada, Hidetoshi Eguchi, Yoshifumi Iwagami, Daisaku Yamada, Tadafumi Asaoka, Takehiro Noda, Kunihito Gotoh, Shogo Kobayashi, Masaki Mori, Yuichiro Doki
Since acinar cell carcinoma(ACC)of pancreas is rare, we sometimes meet a case hard to make diagnosis before surgery. We here reported a case of ACC of pancreas with extensive intraductal growth to the main pancreatic duct and the branch of the pancreatic duct. A 43-year-old man visit a clinic with a concern of uncomfortable feeling on left side abdomen. CT/MRI examination showed a ischemic tumor, 38×25 mm, in the body-tail of the pancreas, and the tumor infiltrated to left renal capsule. ERCP showed the interruption and stenosis of the pancreatic duct at the point adjacent to tumor...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Mingwei Zheng, Xufeng Liu, Ning Li, Wei-Zhi Li
AIM: To evaluate the efficacy and safety of emergency endoscopic needle-knife precut papillotomy in acute severe cholangitis resulting from impacted common bile duct stones at duodenal papilla. METHODS: Between January 2010 and January 2015, 118 cases of acute severe cholangitis with impacted common bile duct stones at the native papilla underwent emergency endoscopic retrograde cholangiopancreatography (ERCP) and early needle-knife precut papillotomy in a tertiary referral center...
November 29, 2017: Digestive and Liver Disease
Usman Iqbal Aujla, Nimzing Ladep, Laura Dwyer, Stephen Hood, Nicholas Stern, Richard Sturgess
AIM: To describe the efficacy and safety of endoscopic papillary large balloon dilatation (EPLBD) in the management of bile duct stones in a Western population. METHODS: Data was collected from the endoscopic retrograde cholangiopancreatography (ERCP) and Radiology electronic database along with a review of case notes over a period of six years from 1st August 2009 to 31st July 2015 and incorporated into Microsoft excel. Statistical analyses were performed using MedCalc for Windows, version 12...
December 28, 2017: World Journal of Gastroenterology: WJG
Kemal Dolay, Mustafa Hasbahçeci, Engin Hatipoğlu, Fatma Ümit Malya, Adem Akçakaya
In the differential diagnosis of biliary obstruction with unknown etiology, biliary fascioliasis should be considered in endemic and nonendemic regions. After diagnostic evaluation, endoscopic retrograde cholangiopancreatography (ERCP) was performed for etiological evaluation and/or treatment of biliary obstruction in five patients with a mean age of 55.8 years. Endoscopic sphincterotomy and cholangiogram revealed linear filling defects in the biliary system. Fasciola hepatica parasites were extracted using balloon and basket catheters in two and three patients, respectively...
January 2018: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
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
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
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
Jianhua Wan, Yaobin Ouyang, Chen Yu, Xiaoyu Yang, Liang Xia, Nonghua Lu
BACKGROUND AND AIMS: Idiopathic acute pancreatitis (IAP) poses a diagnostic challenge for gastroenterologists, because 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 (CP). ERCP, EUS, and MRCP typically are used to diagnose IAP when conventional radiologic methods fail. However, their exact role in the diagnosis of IAP has not yet been determined...
December 7, 2017: Gastrointestinal Endoscopy
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
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
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
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