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Pancreatitis after ERCP

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https://www.readbyqxmd.com/read/27909551/post-endoscopic-retrograde-cholangiopancreatography-pancreatitis-risk-factors-and-predictors-of-severity
#1
Ayman El Nakeeb, Ehab El Hanafy, Tarek Salah, Ehab Atef, Hosam Hamed, Ahmad M Sultan, Emad Hamdy, Mohamed Said, Ahmed A El Geidie, Tharwat Kandil, Mohamed El Shobari, Gamal El Ebidy
AIM: To detect risk factors for post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) and investigate the predictors of its severity. METHODS: This is a prospective cohort study of all patients who underwent ERCP. Pre-ERCP data, intraoperative data, and post-ERCP data were collected. RESULTS: The study population consisted of 996 patients. Their mean age at presentation was 58.42 (± 14.72) years, and there were 454 male and 442 female patients...
November 16, 2016: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27905178/follow-up-to-determine-unplanned-hospitalization-and-complications-after-endoscopic-retrograde-cholangiopancreatography
#2
Edwina Chan, Teresa Neeman, Andrew Thomson
BACKGROUND: Studies of endoscopic retrograde cholangiopancreatography (ERCP)-related complications are inconsistent and sometimes have insufficient patient follow-up. The aim of this study was to investigate risk factors for ERCP-related events, leading to hospitalization in the case of outpatients and prolonged hospital stay in the case of inpatients, using assiduous follow-up and contemporaneous recording of data. METHODS: Prospectively collected data of 1000 consecutive ERCP procedures performed by a single endoscopist at a tertiary referral centre in Canberra, Australia, were studied and the complications evaluated...
December 1, 2016: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/27866907/radiofrequency-ablation-for-intraductal-extension-of-ampullary-neoplasms
#3
Tarun Rustagi, Shayan Irani, D Nageshwar Reddy, Barham K Abu Dayyeh, Todd H Baron, Christopher J Gostout, Michael J Levy, John Martin, Bret T Petersen, Andrew Ross, Mark D Topazian
BACKGROUND AND AIMS: Extension of ampullary adenomas into the common bile duct (CBD) or pancreatic duct (PD) may be difficult to treat endoscopically. We evaluated the feasibility, safety, and efficacy of endoscopic radiofrequency ablation (RFA) in management of ampullary neoplasms with intraductal extension. METHODS: Multicenter, retrospective analysis of all patients with intraductal extension of ampullary neoplasms treated with endoscopic RFA between February 2012 and June 2015...
November 17, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27849643/comparison-of-rectal-indomethacin-diclofenac-and-naproxen-for-the-prevention-of-post-endoscopic-retrograde-cholangiopancreatography-pancreatitis
#4
Amir H Mohammad Alizadeh, Mohammad Abbasinazari, Behzad Hatami, Saeed Abdi, Forozan Ahmadpour, Shideh Dabir, Aida Nematollahi, Samira Fatehi, Mohammad A Pourhoseingholi
BACKGROUND AND AIM: NSAIDs are commonly utilized for the prevention of post endoscopic retrograde cholangiopancreatography pancreatitis (PEP). However, not much is known about the most effective drug in preventing this complication. This study aims to clarify which drug (indomethacin, diclofenac, or naproxen) is most effective for the prevention of post endoscopic retrograde cholangiopancreatography (ERCP). MATERIALS AND METHODS: In a double-blind, randomized study, patients received a single rectal dose of one of the three drugs 30 min before undergoing ERCP: diclofenac (100 mg), indomethacin (100 mg), or naproxen (500 mg)...
November 15, 2016: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27848241/a-mixed-adenoneuroendocrine-carcinoma-of-the-pancreas-a-case-report
#5
Kouki Imaoka, Saburo Fukuda, Hirofumi Tazawa, Yoshio Kuga, Tetsuya Mochizuki, Yuzo Hirata, Seiji Fujisaki, Mamoru Takahashi, Toshihiro Nishida, Hideto Sakimoto
A tumor consisting of an adenocarcinoma component and a neuroendocrine carcinoma component, with each component accounting for at least 30% of the tumor, is defined as a mixed adenoneuroendocrine carcinoma (MANEC). We report a case of MANEC of the pancreas. A 63-year-old man presented with hyperglycemia and was referred to our hospital for further examination. Abdominal contrast-enhanced computed tomography (CT) revealed a mass of 2 cm in size in the pancreas head with portal vein narrowing. Fluorin-18 fluorodeoxyglucose-positron emission tomography (FDG-PET) CT revealed increased accumulation in the mass of the pancreas head...
December 2016: Surgical Case Reports
https://www.readbyqxmd.com/read/27824485/the-value-of-secretin-enhanced-mrcp-in-patients-with-recurrent-acute-pancreatitis
#6
Kumar Sandrasegaran, Bilal Tahir, Udaykamal Barad, Evan Fogel, Fatih Akisik, Temel Tirkes, Stuart Sherman
OBJECTIVE: The purpose of this study is to assess the additional value of secretin-enhanced MRCP over conventional (non-secretin-enhanced) MRCP in diagnosing disease in patients with recurrent acute pancreatitis. MATERIALS AND METHODS: A retrospective review of a radiology database found 72 patients with recurrent acute pancreatitis who had secretin-enhanced MRCP and ERCP correlation within 3 months of each other between January 2007 and December 2011. Of these patients, 54 had no history of pancreatic tumor or surgery and underwent MRI more than 3 months after an episode of acute pancreatitis...
November 8, 2016: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/27816497/lactated-ringer-s-solution-in-combination-with-rectal-indomethacin-for-prevention-of-post-ercp-pancreatitis-and-readmission-a-prospective-randomized-double-blinded-placebo-controlled-trial
#7
Shaffer R S Mok, Henry C Ho, Paurush Shah, Milan Patel, John P Gaughan, Adam B Elfant
BACKGROUND AND AIMS: Prospective data have shown the benefit of rectal indomethacin (IND) for preventing post-ERCP pancreatitis (PEP). A recent pilot study demonstrated a lower incidence of PEP after an 8-hour lactated ringer's (LR) infusion. The aim of this study was to evaluate the efficacy of IND with or without bolus LR in patients at high-risk for PEP. METHODS: In this randomized, double-blinded, placebo-controlled trial we assigned patients to standard normal saline solution (NS)+placebo, NS+IND, LR+placebo or LR+IND...
November 2, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27801342/-the-efficiency-of-different-biliary-cannulation-in-endoscopic-retrograde-cholangiopancreatography-a-meta-analysis
#8
Q Ma, Y D Yao, X X Hou, M C Wang, Z G Wei, J H Tian, Y C Zhang, X D He
Objective: To compare the success rates of wire-guided biliary cannulation (WGC) and conventional cannulation (CC) and their effect on the outcome of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP). Methods: All randomized controlled trials (RCTs) were collected by searching CNKI, WanFang Data, CBM, PubMed, Embase and Cochrane Library.The assessment of methodological quality and data extraction of the included studies were performed independently by two reviewers. Meta-analysis was conducted with RevMan 5...
November 1, 2016: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/27797266/identification-of-pancreatic-cancer-in-biliary-obstruction-patients-by-fry-site-specific-methylation
#9
Phonthep Angsuwatcharakon, Rungsun Rerknimitr, Pradermchai Kongkam, Wiriyaporn Ridtitid, Yuwadee Ponauthai, Ratakorn Srisuttee, Nakarin Kitkumthorn, Apiwat Mutirangura
BACKGROUND: Methylation at cg 16941656 of FRY is exclusively found in normal pancreatic tissue and has been proven to be specific for pancreatic-in-origin among several adenocarcinomas. Here, we investigated methylated DNA in the bile as a biomarker to differentiate the cause of obstruction between pancreatic cancer and benign causes. MATERIALS AND METHODS: Bile samples of 45 patients with obstructive jaundice who underwent ERCP were collected and classified into pancreatic cancer (group 1) and benign causes (group 2) in 24 and 21 patients, respectively...
2016: Asian Pacific Journal of Cancer Prevention: APJCP
https://www.readbyqxmd.com/read/27796634/cholecystectomy-reduces-recurrent-pancreatitis-and-improves-survival-after-endoscopic-sphincterotomy
#10
Shih-Hao Young, Yen-Ling Peng, Xi-Hsuan Lin, Yung-Tai Chen, Jiing-Chyuan Luo, Yen-Po Wang, Ming-Chih Hou, Fa-Yauh Lee
BACKGROUND: The aim of this study was to assess whether cholecystectomy can decrease the recurrent pancreatitis in the elderly patients who received endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic sphincterotomy (EST) and successful clearance of bile duct (BD) stones after gallstone-related acute pancreatitis. METHODS: We analyzed data from National Health Insurance Research Database of Taiwan. Elderly patients (age ≧70 years old) who had gallstone-related acute pancreatitis and underwent successful EST with BD stones clearance were eligible for enrollment...
October 27, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/27747287/use-of-double-wire-guided-technique-and-transpancreatic-papillary-septotomy-in-difficult-ercp-4-year-experience
#11
Connie Huang, Jonathan Kung, Yong Liu, Audrey Tse, Anuj Datta, Inder Singh, Viktor E Eysselein, Sofiya Reicher
Background and aims: Post-ERCP complications increase with repeated attempts at cannulation. We evaluated several advanced biliary cannulation techniques applied when the standard approach fails. Methods: In total, 1873 consecutive patients underwent ERCP at our institution during the period 2010 - 2014. Guidewire-assisted (GA) cannulation with no contrast injection until deep biliary cannulation was considered the standard technique. Advanced techniques used were double wire-guided (DWG) cannulation, transpancreatic papillary septotomy (TPS), and needle-knife sphincterotomy (NKS)...
October 2016: Endoscopy International Open
https://www.readbyqxmd.com/read/27747282/intravenous-injection-of-low-dose-flurbiprofen-axetil-for-preventing-post-ercp-pancreatitis-in-high-risk-patients-an-interim-analysis-of-the-trial
#12
Yuji Fujita, Sho Hasegawa, Yuri Kato, Ken Ishii, Akito Iwasaki, Takamitsu Sato, Yusuke Sekino, Kunihiro Hosono, Atsushi Nakajima, Kensuke Kubota
Background and study aims: Several meta-analyses and randomized control trials have demonstrated the efficacy of rectal nonsteroidal anti-inflammatory drugs for preventing post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP). Diclofenac or indomethacin was administered at a dose of 100 mg in those studies, which may be too high for Asian population. In addition, rectal administration can be considered complicated. Patients and methods: This study was a prospective, randomized, placebo-controlled trial...
October 2016: Endoscopy International Open
https://www.readbyqxmd.com/read/27700180/acute-biliary-pancreatitis-focus-on-recurrence-rate-and-costs-when-current-guidelines-are-not-complied
#13
Tim Ragnarsson, Roland Andersson, Daniel Ansari, Ulf Persson, Bodil Andersson
BACKGROUND: International guidelines recommend cholecystectomy within 2-4 weeks after mild-moderate acute biliary pancreatitis (ABP) to prevent recurrence. We aimed to investigate the compliance to guidelines concerning early cholecystectomy and the associated costs. METHODS: Admissions for ABP 2011-2013 were retrospectively reviewed. Classification was made according to the revised Atlanta classification. Treatment, time to surgery and recurrence, as well as cost analysis for both in-hospital costs and loss of production was performed...
October 4, 2016: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/27690682/impact-of-nitroglycerin-and-glucagon-administration-on-selective-common-bile-duct-cannulation-and-prevention-of-post-ercp-pancreatitis
#14
Panagiotis Katsinelos, Georgia Lazaraki, Grigoris Chatzimavroudis, Taxiarchis Katsinelos, Nikos Georgakis, Kyriaki Anastasiadou, Anthi Gatopoulou, Christos Zeglinas, Kyriakos Psarras, Jannis Kountouras
OBJECTIVE: Easy common bile duct (CBD) cannulation is associated with low complication rate. This study aimed to investigate the potential impact of nitroglycerin and glucagon administration on selective CBD cannulation and prevention of post-ERCP pancreatitis. METHODS: A prospective single center, double-blind randomized study in which a total of 455 patients were randomly assigned to CBD cannulation by receiving 6 puffs (2.4 mg) sublingual nitroglycerin and glucagon 1 mg intravenously (n = 227, group A) or 6 puffs sterile water and 20 mg hyoscine-n-butyl bromide intravenously (n = 228, group B)...
October 3, 2016: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/27678352/management-of-patients-after-recovering-from-acute-severe-biliary-pancreatitis
#15
REVIEW
Georgia Dedemadi, Manolis Nikolopoulos, Ioannis Kalaitzopoulos, George Sgourakis
Cholelithiasis is the most common cause of acute pancreatitis, accounting 35%-60% of cases. Around 15%-20% of patients suffer a severe attack with high morbidity and mortality rates. As far as treatment is concerned, the optimum method of late management of patients with severe acute biliary pancreatitis is still contentious and the main question is over the correct timing of every intervention. Patients after recovering from an acute episode of severe biliary pancreatitis can be offered alternative options in their management, including cholecystectomy, endoscopic retrograde cholangiopancreatography (ERCP) and sphincterotomy, or no definitive treatment...
September 14, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27651353/prophylaxis-of-pancreatitis-with-intravenous-ketoprofen-in-a-consecutive-population-of-ercp-patients-a-randomized-double-blind-placebo-controlled-trial
#16
Fernanda de Quadros Onófrio, Julio Carlos Pereira Lima, Guilherme Watte, Romnei Lenon Lehmen, Daniela Oba, Gabriela Camargo, Carlos Eduardo Oliveira Dos Santos
Background Acute pancreatitis is the most common complication after ERCP, occurring in about 4 % of the procedures. Only the placement of pancreatic duct prosthesis and the use of nonsteroidal anti-inflammatory drugs (NSAIDs) have shown benefit in the prevention of post-ERCP pancreatitis (PEP). Although the benefit of rectal administration of indomethacin or diclofenac is recommended by some studies and society guidelines especially in a selected group of high-risk patients, there is so far, no standardization of time or route of NSAID administration...
September 20, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27642079/il-6-il-10-and-tnf%C3%AE-do-not-improve-early-detection-of-post-endoscopic-retrograde-cholangiopancreatography-acute-pancreatitis-a-prospective-cohort-study
#17
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
https://www.readbyqxmd.com/read/27641151/mediastinal-pancreatic-pseudocysts
#18
Krzysztof Dąbkowski, Andrzej Białek, Maciej Kukla, Janusz Wójcik, Andrzej Smereczyński, Katarzyna Kołaczyk, Tomasz Grodzki, Teresa Starzyńska
Mediastinal pseudocysts are a rare complication of acute pancreatitis. Lack of uniform treatment standards makes the management of this condition a clinical challenge. We report the case of a 43-year-old patient who presented with a left pleural effusion. Pleural fluid revealed a high amylase concentration consistent with a pancreaticopleural fistula. Endoscopic retrograde cholangiopancreatography (ERCP) revealed a disruption of the pancreatic duct with free outflow of contrast medium into the thoracic cavity...
September 13, 2016: Clinical Endoscopy
https://www.readbyqxmd.com/read/27639800/eus-guided-methylene-blue-injection-to-facilitate-pancreatic-duct-access-after-unsuccessful-ercp
#19
B Joseph Elmunzer, Cyrus R Piraka
No abstract text is available yet for this article.
September 14, 2016: Gastroenterology
https://www.readbyqxmd.com/read/27638137/double-guidewire-endoscopic-technique-a-major-evolution-in-endoscopic-retrograde-cholangiopancreatography-results-of-a-retrospective-study-with-historical-controls-comparing-two-therapeutic-sequential-strategies
#20
Arthur Laquiere, Etienne Desilets, Arthur Belle, Paul Castellani, Philippe Grandval, René Laugier, Guillaume Penaranda, Laurence Lecomte, Christian Boustiere
BACKGROUND AND AIM: Endoscopic access to the common bile duct (CBD) remains difficult in 10% of cases, requiring alternative techniques .CBD access was difficult after either five unsuccessful attempts, five unintentional insertions into the pancreatic duct or >10-min-long unsuccessful attempts. This retrospective study with historical controls aimed to evaluate the benefit of the double guidewire (DGW) technique after failure of standard CBD cannulation. METHODS: From January 2012 to December 2014, all patients requiring therapeutic endoscopic retrograde cholangiopancreatography (ERCP) with difficult access to CBD were included in a Studied group...
September 17, 2016: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
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