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Post ercp pancreatitis

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https://www.readbyqxmd.com/read/28093301/protocol-driven-management-of-suspected-common-duct-stones
#1
Anthony Manning, Richard Frazee, Stephen Abernathy, Claire Isbell, Travis Isbell, Justin Regner, Yolanda Munoz Maldanado, Randall Smith
INTRO: Common duct stones can be diagnosed by magnetic resonance cholangiopancreatography (MRCP), endoscopic ultrasound/endoscopic retrograde cholangiopancreatography (EUS/ERCP), and intra-operative cholangiogram (IOC). In 2015, our group adopted a standard approach of preoperative EUS/ERCP followed by laparoscopic cholecystectomy for patients with an admission bilirubin over 4.0 (mg/dL). For bilirubin less than 4.0, laparoscopic cholecystectomy with IOC was the initial procedure. Post-operative EUS/ERCP with endoscopic sphincterotomy was pursued for positive IOC...
January 13, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28090570/targeted-inhibition-of-pancreatic-acinar-cell-calcineurin-is-a-novel-strategy-to-prevent-post-ercp-pancreatitis
#2
Abrahim I Orabi, Li Wen, Tanveer A Javed, Tianming Le, Ping Guo, Subramaniam Sanker, David Ricks, Kristy Boggs, John F Eisses, Carlos Castro, Xiangwei Xiao, Krishna Prasadan, Farzad Esni, George K Gittes, Sohail Z Husain
BACKGROUND AND AIMS: There is a pressing need to develop effective preventative therapies for post-ERCP pancreatitis (PEP). We demonstrated that early PEP events are induced through the calcium-activated phosphatase calcineurin and that global calcineurin deletion abolishes PEP in mice. A crucial question is whether acinar cell calcineurin controls the initiation of PEP in vivo. METHODS: We used a mouse model of PEP and examined the effects of in vivo acinar cell-specific calcineurin deletion by either generating a conditional knockout line or infusing a novel AAV-Ela-iCre into the pancreatic duct of a calcineurin floxed line...
January 2017: Cellular and Molecular Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28074451/ercp-with-stenting-of-traumatic-pancreatic-duct-transection-a-case-report
#3
Deepa Prashant Makhija, Jayesh Desale, Charu Tiwari, Hemanshi Shah
Pancreatic injuries, though rare, are associated with high morbidity because of location of pancreas adjacent to the various hollow and solid organs. Difficulty in early diagnosis adds to morbidity. Condition of the pancreatic duct is an important factor in grading the injury and deciding upon course of management. Conservative management is the line of treatment in lower grade injuries. Higher grades of pancreatic injuries are usually managed surgically. Endoscopic retrograde cholangiopancreaticography (ERCP) has recently emerged as an effective diagnostic as well as therapeutic modality for hepatobiliary and pancreatic pathologies...
November 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28065885/endoscopic-retrograde-cholangiopancreatography-with-ampullary-biopsy-vs-ercp-alone-a-matched-pairs-controlled-evaluation-of-outcomes-and-complications
#4
Sunil Dacha, Saurabh Chawla, Jai Eun Lee, Steven A Keilin, Qiang Cai, Field F Willingham
BACKGROUND AND AIMS: Biopsy of the ampulla of Vater may be performed to evaluate for ampullary adenomas, suspected ampullary tumors and immunohistological staining for autoimmune pancreatitis. Ampullary biopsies are commonly performed at the time of endoscopic retrograde cholangiopancreatography (ERCP). Due to the well-established complication rate following ERCP, the contribution of ampullary biopsy as a potential independent risk factor would require a controlled comparison. METHODS: A matched-pairs, case-control analysis was performed for patients undergoing ERCP with or without ampullary biopsy...
January 8, 2017: Gastroenterology Report
https://www.readbyqxmd.com/read/28062312/incidence-and-risk-factors-for-post-ercp-pancreatitis-in-chronic-pancreatitis
#5
Zhen-Hua Zhao, Liang-Hao Hu, Hong-Bo Ren, An-Jing Zhao, Yang-Yang Qian, Xiao-Tian Sun, Song Su, Shu-Guang Zhu, Jin Yu, Wen-Bin Zou, Xiao-Rong Guo, Lei Wang, Zhao-Shen Li, Zhuan Liao
BACKGROUND AND AIMS: Almost all studies on post-ERCP pancreatitis (PEP) have mainly involved patients with biliary diseases, rather than chronic pancreatitis; and the concept that chronic pancreatitis (CP) seems to be a protective factor associated with PEP has not been studied in detail. The aim of this study was to determine the incidence of PEP in patients with CP at different clinical stages and to identify the predictive and protective factors of PEP in a large cohort. METHODS: This is an observational cohort study...
January 3, 2017: Gastrointestinal Endoscopy
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
#6
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/28027415/is-rectal-indomethacin-ineffective-in-the-prevention-of-post-ercp-pancreatitis-in-general-population
#7
Chongrong Shen, Yanqiang Shi, Peizhu Su
We read with interest the meta-analyses by Feng et al (1) and by Inamdar et al (2) , objecting to the use of rectal indomethacin for post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) prophylaxis in "average-risk patients" and in general patients, respectively, through analysing the same six randomized controlled trials (RCT) where patients were unselected. Inamdar et al defined "average-risk patients" as patients not meeting criteria for high-risk patients for PEP. (2) However, five RCTs in the meta-analysis included a proportion of high-risk patients...
December 27, 2016: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28018225/role-of-somatostatin-in-preventing-post-endoscopic-retrograde-cholangiopancreatography-ercp-pancreatitis-an-update-meta-analysis
#8
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
#9
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/27997966/double-guidewire-technique-in-difficult-biliary-cannulation-for-the-prevention-of-post-ercp-pancreatitis-a-systematic-review-and-meta-analysis
#10
Frances Tse, Yuhong Yuan, Paul Moayyedi, Grigorios I Leontiadis, Alan N Barkun
Background and study aims Difficult cannulation is a risk factor for pancreatitis following endoscopic retrograde cholangiopancreatography (ERCP). The double-guidewire technique (DGT) may improve cannulation success and reduce the risk of post-ERCP pancreatitis (PEP) in patients with difficult cannulation. This systematic review compared the DGT with persistent conventional cannulation or other advanced techniques in patients with difficult cannulation. Patients and Methods CENTRAL, MEDLINE, EMBASE, and CINAHL databases and DDW and UEGW abstracts up to March 2016 were searched for randomized controlled trials (RCTs) comparing DGT with persistent conventional cannulation or other advanced techniques (precut, pancreatic duct [PD] stenting)...
January 2017: Endoscopy
https://www.readbyqxmd.com/read/27987277/eculizumab-refractory-thrombotic-thrombocytopenic-purpura-secondary-to-post-endoscopic-retrograde-cholangiopancreatography-pancreatitis-in-a-patient
#11
Faizan Malik, Naveed Ali, Irfan Ahsan, Ali Raza Ghani, Christian Fidler
Thrombotic thrombocytopenic purpura (TTP) is a rare multisystem microvascular disorder, which is characterized by pentad of thrombocytopenia, microangiopathic hemolytic anemia, and organ dysfunction due to occlusive thrombi. The proposed pathophysiology involves an imbalance between unusually large von Willebrand factor multimers and the cleaving protease ADAMTS13. Acute pancreatitis is a well-described consequence of TTP, but TTP secondary to acute pancreatitis is a rare phenomenon. We present a patient who developed TTP due to post-ERCP pancreatitis with hematologic, cardiovascular, pulmonary, and renal complications and is the first case of this kind...
2016: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/27981825/laparo-endoscopic-rendez-vous-versus-sequential-delayed-approach-in-patients-with-choledocholithiasis
#12
Antonio Pesce, Gaetano LA Greca, Saverio Latteri, Vincenzo Guardabasso, Federica DI Marco, Michele DI Blasi, Domenico Russello, Stefano Puleo
BACKGROUND: To compare the efficacy and safety of synchronous laparoscopic cholecystectomy with laparo-endoscopic rendez-vous technique vs sequential "delayed" approach with the main goal to compare the conversion rate and post-operative complications. METHODS: Patients diagnosed as having gallstones and CBD stones or sludge were enrolled in this study. From January 2013 to June 2015, 43 consecutive patients were submitted to the sequential treatment (ERCP prior to laparoscopic cholecystectomy) and the next consecutive 46 patients were submitted to undergo the rendez-vous technique...
December 16, 2016: Minerva Chirurgica
https://www.readbyqxmd.com/read/27957289/efficacy-of-endoscopic-ultrasonography-in-evaluation-of-undetermined-etiology-of-common-bile-duct-dilatation-on-abdominal-ultrasonography
#13
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
https://www.readbyqxmd.com/read/27938583/-meta-analysis-somatostatin-for-prophylaxis-against-post-endoscopic-retrograde-cholangiopancreatography-pancreatitis
#14
S B Pan, X P Geng
Objective: To evaluate the efficacy of somatostatin in preventing pancreatitis after endoscopic retrograde cholangiopancreatography(ERCP). Methods: A standardized comprehensive literature search was performed by Cochrane library, PubMed, OVID, Springer Linker, Science Direct, EBSCO. Randomized controlled studies on the prevention of pancreatitis after ERCP before Octorber 2015 were enrolled in the study and were analyzed by 2 independent reviewers. Random-effects model(REM) or fixed-effects model (FEM) was applied to calculate pooled estimates of drug efficacy depending on the outcomes...
1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/27932176/intrahepatic-artery-pseudoaneurysm-induced-hemobilia-caused-by-a-plastic-biliary-stent-after-abo-incompatible-living-donor-liver-transplantation-a-case-report
#15
J M Chun, H T Ha, Y Y Choi, Y J Hwang, J Heo, H K Ryeom, Y S Han
Bile leakage after duct-to-duct anastomosis in living-donor liver transplantation (LDLT) can mostly be managed by therapeutic endoscopic retrograde cholangiopancreatography. Following this, various complications such as biliary infection, pancreatitis, perforation, and bleeding can occur, and endoscopic sphincterotomy is primarily associated with post- endoscopic retrograde cholangiopancreatography bleeding; other causes have been published in case reports. In the present case, a plastic biliary stent used for treating liver abscesses and leakage at the bile duct anastomosis site after ABO-incompatible LDLT resulted in an intrahepatic artery pseudoaneurysm and hemobilia, which were managed by angiography and coil embolization...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27931637/complications-of-ercp
#16
REVIEW
Rupjyoti Talukdar
Even though considered safe, endoscopic retrograde cholangiopancreatography (ERCP) is among the endoscopic procedures associated with the highest rate of complications. Post ERCP pancreatitis (PEP) is the most common complication of ERCP. Several independent risk factors have been associated with PEP. Prophylactic PD stenting has been shown to be highly effective in preventing PEP. More recent studies have suggested that NSAIDs, especially rectal indomethacin, could by itself be effective in preventing PEP...
October 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27924097/editorial-guidewire-trauma-a-key-component-of-post-ercp-pancreatitis-that-is-best-controlled-by-the-endoscopist
#17
Indu Srinivasan, Martin L Freeman
Recent studies have revealed that deep pancreatic duct wire passage, even in the absence of contrast injection, is a major technique-related culprit in post-ERCP pancreatitis, unless followed by placement of a pancreatic stent. As guidewire cannulation becomes increasingly widespread, precise control of the guidewire is thus critical. The first randomized trial to compare endoscopist-controlled wire guided vs. assistant-controlled bile duct cannulation has shown a significant reduction in post ERCP pancreatitis when the physician manipulates the wire...
December 2016: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/27917812/nasobiliary-drainage-for%C3%A2-benign-recurrent-intrahepatic-cholestasis%C3%A2-in-patients-refractory-to-standard-therapy
#18
Tolga Yakar, Mehmet Demir, Huseyin S Gokturk, Ayse G Unler Kanat, Alper Parlakgumus, Birol Ozer, Ender Serin
PURPOSE: Benign recurrent intrahepatic cholestasis (BRIC) is characterized by episodic cholestasis and pruritus without anatomical obstruction. The aim of this study was to evaluate the safety and efficacy of nasobiliary drainage (NBD) in patients with BRIC refractory to medical therapy and to determine whether the use of NBD prolongs the episode duration. METHODS: This was a multicenter retrospective study consisting of 33 patients suffering from BRIC. All patients were administrated medical treatment and 16 patients who were refractory to standard medical therapies improved on treatment with temporary endoscopic NBD...
1, 2016: Clinical and Investigative Medicine. Médecine Clinique et Experimentale
https://www.readbyqxmd.com/read/27914176/prophylactic-rectal-indomethacin-may-be-ineffective-for-preventing-post-endoscopic-retrograde-cholangiopancreatography-pancreatitis-in-general-patients-a-meta-analysis
#19
REVIEW
Yunlu Feng, Udayakumar Navaneethan, Xiang Zhu, Shyam Varadarajulu, Ingrid Schwartz, Robert Hawes, Muhammad Hasan, Aiming Yang
BACKGROUND AND AIM: Efficacy of prophylactic indomethacin for prevention of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) in general patients remains controversial. To address this, we conducted a meta-analysis of clinical trials specifically on rectal indomethacin in prevention of PEP in consecutive patients undergoing ERCP. METHODS: We searched MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials databases to identify randomized, double-blind, controlled clinical trials on rectal indomethacin in the prevention of PEP in consecutive patients undergoing ERCP...
December 3, 2016: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/27909551/post-endoscopic-retrograde-cholangiopancreatography-pancreatitis-risk-factors-and-predictors-of-severity
#20
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
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