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Post ercp pancreatitis

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https://www.readbyqxmd.com/read/28636774/reducing-the-risk-of-post-ercp-pancreatitis
#1
REVIEW
B Joseph Elmunzer
Pancreatitis is the most common and potentially devastating complication of endoscopic retrograde cholangiopancreatography (ERCP), resulting in significant morbidity, occasional mortality, and increased healthcare expenditures. Accordingly, the prevention of post-ERCP pancreatitis (PEP) remains a major clinical and research priority. Strategies to reduce the incidence of PEP include thoughtful patient selection, appropriate risk-stratification, sound procedural technique, prophylactic pancreatic stent placement, and pharmacoprevention...
June 21, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28614171/the-role-safety-steps-in-success-and-complication-rate-of-endoscopic-retrograde-cholangiopancreatography
#2
Bariş Sevinç, Ömer Karahan
BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) is widely used for treatment of biliary disorders. There are several studies to increase the success rate and decrease the complication rate of ERCP. In this study we aimed to evaluate the affect of safety steps in success and complication rate of ERCP. MATERIALS AND METHODS: In this cohort study patients were evaluated under 2 groups divided as before the introduction of safety steps and after. Successful cannulation rate, difficult cannulations, and complications of the procedure were recorded...
June 13, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28609791/transpancreatic-sphincterotomy-has-a-higher-cannulation-success-rate-than-needle-knife-precut-papillotomy-a-meta-analysis
#3
Dániel Pécsi, Nelli Farkas, Péter Hegyi, Márta Balaskó, József Czimmer, András Garami, Anita Illés, Dóra Mosztbacher, Gabriella Pár, Andrea Párniczky, Patrícia Sarlós, Imre Szabó, Kata Szemes, Ákos Szűcs, Áron Vincze
Background and aim While many studies have discussed the different cannulation techniques used in patients with difficult biliary access, no previous meta-analyses have compared transpancreatic sphincterotomy (TPS) to other advanced techniques. Therefore, we aimed to identify all studies comparing the efficacy and adverse event rates of TPS with needle-knife precut papillotomy (NKPP), the most commonly used technique, and to perform a meta-analysis. Methods The Embase, PubMed, and Cochrane databases were searched for trials comparing the outcomes of TPS with NKPP up till December 2016...
June 13, 2017: Endoscopy
https://www.readbyqxmd.com/read/28609383/the-efficiency-of-aggressive-hydration-with-lactated-ringer-solution-for-the-prevention-of-post-ercp-pancreatitis-a-systematic-review-and-meta-analysis
#4
Dangyan Wu, Jianhua Wan, Liang Xia, Jie Chen, Yin Zhu, Nonghua Lu
BACKGROUND: As shown in studies, aggressive hydration during the perioperative period of endoscopic retrograde cholangiopancreatography (ERCP) effectively prevents post-ERCP pancreatitis (PEP). We conducted a systematic review and meta-analysis to evaluate the clinical effectiveness and safety of aggressive hydration with lactated Ringer solution at preventing PEP. MATERIALS AND METHODS: We searched all relevant research from PubMed, the Cochrane Library, Embase, the Web of Science, ClinicalTrial...
June 12, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28606848/association-between-endoscopist-and-center-ercp-volume-with-procedure-success-and-adverse-outcomes-a-systematic-review-and-meta-analysis
#5
REVIEW
Rajesh N Keswani, Bashar J Qumseya, Linda C O'Dwyer, Sachin Wani
BACKGROUND AND AIMS: ERCP has become a predominantly therapeutic intervention with a resultant increase in complexity. The relationship between ERCP volume and outcomes is unclear. We aimed to conduct a systematic review and meta-analysis assessing the relationship between endoscopist and center ERCP volume with (i) ERCP success; and (ii) adverse event (AE) rates. METHODS: A comprehensive search of MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials was conducted from inception to January 2017...
June 9, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28603054/comparable-long-term-outcomes-of-1-minute-vs-5-minute-endoscopic-papillary-balloon-dilation-for-bile-duct-stones
#6
Yu-Ting Kuo, Hsiu-Po Wang, Chi-Yang Chang, Joseph W Leung, Jiann-Hwa Chen, Ming-Chang Tsai, Wei-Chih Liao
BACKGROUND & AIMS: Endoscopic papillary balloon dilation (EPBD) is an alternative to endoscopic sphincterotomy (EST) for choledocholithiasis. Unlike EST, EPBD preserves biliary sphincter function, reducing long-term risk of recurrent choledocholithiasis by 50%. Guidelines recommend that duration of EPBD exceeds 2 minutes, to adequately loosen the sphincter and reduce risks of failed stone extraction and post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis. However, it is unclear whether this long duration of EPBD impairs sphincter function and negates the long-term benefit of EPBD...
June 8, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28561199/efficacy-of-self-expandable-metal-stents-in-management-of-benign-biliary-strictures-and-comparison-with-multiple-plastic-stents-a-meta-analysis
#7
Muhammad Ali Khan, Todd H Baron, Faisal Kamal, Bilal Ali, Richard Nollan, Mohammad Kashif Ismail, Claudio Tombazzi, Everson L A Artifon, Alessandro Repici, Mouen A Khashab
Background and study aims There is burgeoning interest in the utilization of covered self-expandable metal stents (CSEMSs) for managing benign biliary stricture (BBS). This systematic review and meta-analysis evaluated cumulative stricture resolution and recurrence rates using CSEMSs and compared performance of CSEMSs and multiple plastic stents (MPS) in BBS management. Method Searches in several databases identified studies including ≥ 10 patients that utilized CSEMSs for BBS treatment. Weighted pooled rates were calculated for stricture resolution and recurrence...
May 24, 2017: Endoscopy
https://www.readbyqxmd.com/read/28558658/therapeutic-outcomes-of-endoscopic-papillectomy-for-ampullary-neoplasms-retrospective-analysis-of-a-multicenter-study
#8
Sung Hoon Kang, Kook Hyun Kim, Tae Nyeun Kim, Min Kyu Jung, Chang Min Cho, Kwang Bum Cho, Ji Min Han, Ho Gak Kim, Hyun Soo Kim
BACKGROUND: Endoscopic papillectomy (EP) is reported to be a relatively safe and reliable procedure for complete resection of ampullary neoplasms. The aim of this study was to evaluate the therapeutic outcomes and complications of EP for ampullary neoplasms. METHODS: A retrospective multicenter study was conducted with 5 participating centers from January 2007 to July 2014. A total of 104 patients who underwent EP for ampullary neoplasms were reviewed retrospectively...
May 30, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/28545067/identification-of-risk-factors-for-post-endoscopic-retrograde-cholangiopancreatography-pancreatitis-in-a-high-volume-center
#9
Veit Phillip, Miriam Schwab, David Haf, Hana Algül
BACKGROUND/OBJECTIVES: Pancreatitis is the most common complication of endoscopic retrograde cholangiopancreatography (ERCP). Several patients´ or procedure related risk factors for post-ERCP pancreatitis (PEP) have been suggested. The aim of this study was to validate the risk factors for PEP in a high-volume center. METHODS: All patients undergoing first time ERCP at a tertiary referral center between December 2010 and October 2013 were retrospectively included...
2017: PloS One
https://www.readbyqxmd.com/read/28539848/medications-and-methods-for-the-prevention-of-post-ercp-pancreatitis
#10
Andrew Y Wang
No abstract text is available yet for this article.
March 2017: Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28534552/-perforations-following-endoscopic-retrograde-cholangiopancreatography-ercp
#11
J Mateo Retuerta, C Chaveli Díaz, A Goikoetxea Urdiain, B Sainz Villacampa, M J Sara Ongay, J J Íñigo Noain
Endoscopic retrograde cholangiopancreatography (ERCP) associated with sphincterotomy is a useful procedure that is widely used in cases of choledocholithiasis and bile duct obstruction. In spite of being a safe test, there is a risk of complications like pancreatitis, haemorrhaging or perforation. Post-ERCP duodenal perforation is a rare event but has serious consequences if it is not treated early. The lesion mechanism, the place and extension of the perforation, as well as the clinical picture and radiographic findings will guide patient management, which must be individualised and constantly reevaluated...
April 30, 2017: Anales del Sistema Sanitario de Navarra
https://www.readbyqxmd.com/read/28512648/revision-of-biliary-sphincterotomy-by-re-cut-balloon-dilation-or-temporary-stenting-comparison-of-clinical-outcome-and-complication-rate-with-video
#12
Gianfranco Donatelli, Jean-Loup Dumont, Fabrizio Cereatti, Thierry Tuszynski, Bertrand Marie Vergeau, Bruno Meduri
Background and study aims Revision of endoscopic retrograde cholangiopancreatography (ERCP) may be necessary following previous biliary endoscopic sphincterotomy for recurrent biliary symptoms related to biliary stone recurrence, cholangitis or post-biliary endoscopic sphincterotomy (bEST) papillary stenosis and cholestasis. The aim of this retrospective study was to evaluate the clinical outcome and complication rate associated with re-cut, balloon dilation and biliary metal stenting in revision ERCP. Patients and methods From January 2010 to January 2015, 139 subjects with stigma of a previous sphincterotomy required a revision ERCP (64 Men/75 Women; mean age 71 years; range 32 - 101 years)...
May 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28496535/spontaneous-rupture-of-a-choledochal-cyst-during-post-partum-a-rare-presentation
#13
Ashish Gupta, Karikal Chakaravarthi, Lileswar Kaman
With the advent of newer radiological investigations, choledochal cysts are being diagnosed more often in present era. These cysts are commonly diagnosed in early childhood and infancy, although some go undetected to be diagnosed in adulthood. These malformations are associated with multiple complications like cholangitis, jaundice, pancreatitis, rupture or even malignancy. Here we describe a post partum female, who was diagnosed to have choledochal cyst during sixth month of pregnancy. She presented with obstructive jaundice in cholangitis and was subjected to endoscopic retrograde cholangiopancreatography (ERCP) with stenting...
April 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28488091/outcomes-of-endoscopic-retrograde-cholangiopancreatography-ercp-and-sphincterotomy-for-suspected-sphincter-of-oddi-dysfunction-sod-post-roux-en-y-gastric-bypass
#14
Chin Hong Lim, Cyrus Jahansouz, Martin L Freeman, Daniel B Leslie, Sayeed Ikramuddin, Stuart K Amateau
BACKGROUND: Sphincter of Oddi dysfunction (SOD) is thought to be a cause of chronic abdominal pain post Roux-en-Y gastric bypass, and current practice of performing endoscopic retrograde cholangiopancreatography (ERCP) with or without sphincterotomy is not supported by evidence. In addition to the complexity and risks of the procedure in patients with Roux-en-Y anatomy, the outcomes are uncertain and debatable. We performed a retrospective review and analysis of post-gastric bypass patients who had undergone ERCP with sphincterotomy to determine the effectiveness in patients with suspected SOD...
May 9, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28487727/number-of-endoscopic-retrograde-cholangiopancreatography-procedures-required-for-short-biliary-cannulation-time
#15
Koichiro Mandai, Koji Uno, Yasutoshi Fujii, Takuji Kawamura, Kenjiro Yasuda
Background. Several previous studies assessed the competence in endoscopic retrograde cholangiopancreatography (ERCP) using the bile duct cannulation success rate. However, the cannulation time is also important, because a long cannulation time was reported to be a risk factor for post-ERCP pancreatitis. Aim. To determine the number of ERCP procedures required for short cannulation time of the bile duct. Methods. We retrospectively analyzed 605 ERCP procedures performed for bile duct cannulation in patients with native papilla at our institution between March 2012 and December 2015...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28465786/analysis-of-the-risk-factors-for-severity-in-post-endoscopic-retrograde-cholangiopancreatography-pancreatitis-the-indication-of-prophylactic-treatments
#16
Hiroshi Matsubara, Fumihiro Urano, Yuki Kinoshita, Shozo Okamura, Hiroki Kawashima, Hidemi Goto, Yoshiki Hirooka
AIM: To determine the risk factors of severe post endoscopic retrograde cholangiopancreatography pancreatitis (sPEP) and clarify the indication of prophylactic treatments. METHODS: At our hospital, endoscopic retrograde cholangiopancreatography (ERCP) was performed on 1507 patients from May 2012 to December 2015. Of these patients, we enrolled all 121 patients that were diagnosed with post endoscopic retrograde PEP. Fourteen of 121 patients diagnosed as sPEP were analyzed...
April 16, 2017: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28455159/metal-versus-plastic-stents-for-anastomotic-biliary-strictures-after-liver-transplantation-a-randomized-controlled-trial
#17
Fernanda Prata Martins, Gustavo Andrade De Paulo, Mônica L C Contini, Angelo Paulo Ferrari
BACKGROUND AND AIMS: Biliary anastomotic stricture occurs in 15% to 20% of patients after deceased orthotopic liver transplantation (OLT). It is usually treated endoscopically with multiple plastic stents (MPSs), although the use of fully covered self-expandable metal stents (cSEMSs) is emerging. This study aims to compare the efficacy and safety of cSEMSs versus MPSs in these patients. METHODS: A single-center, open-label, randomized clinical trial was performed...
April 25, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28440297/efficacy-and-safety-of-rectal-nonsteroidal-anti-inflammatory-drugs-for-prophylaxis-against-post-ercp-pancreatitis-a-systematic-review-and-meta-analysis
#18
Yi-Chao Hou, Qiang Hu, Jiao Huang, Jing-Yuan Fang, Hua Xiong
Rectal nonsteroidal anti-inflammatory drugs (NSAIDs) are not commonly used clinically for preventing post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis. To evaluate the efficacy and safety of NSAIDs for post-ERCP prophylaxis, we systematically reviewed sixteen randomized controlled trials (involving 6458 patients) that compared rectal NSAIDs with placebo or no treatment for post-ERCP pancreatitis prophylaxis updated to August 2016. GRADE framework was used to assess the quality of evidence...
April 25, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28411755/combination-pharmacoprophylaxis-for-post-ercp-pancreatitis-working-toward-an-evidence-base
#19
EDITORIAL
B Joseph Elmunzer
No abstract text is available yet for this article.
May 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28405329/the-impact-of-prophylactic-pancreatic-stenting-on-post-ercp-pancreatitis-a-nationwide-register-based-study
#20
Greger Olsson, Jeanne Lübbe, Urban Arnelo, Eduard Jonas, Björn Törnqvist, Lars Lundell, Lars Enochsson
BACKGROUND AND OBJECTIVES: The role of prophylactic pancreatic stenting (PS) in preventing post-endoscopic retrograde cholangio-pancreatography (ERCP) pancreatitis (PEP) has yet to be determined. Most previous studies show beneficial effects in reducing PEP when prophylactic pancreatic stents are used, especially in high-risk ERCP procedures. The present study aimed to address the use of PS in a nationwide register-based study in which the primary outcome was the prophylactic effect of PS in reducing PEP...
February 2017: United European Gastroenterology Journal
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