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Post ercp pancreatitis

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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
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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). 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 efficacy and safety of cSEMSs versus MPSs in these patients. METHODS: single center, open-label, randomized clinical trial. Patients were randomized to single cSEMSs for 6 months or to MPS placement, exchanged every 3 months during 1 year...
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
#7
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
#8
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
#9
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
https://www.readbyqxmd.com/read/28393104/safety-of-ercp-in-patients-with-liver-cirrhosis-a-national-database-study
#10
Udayakumar Navaneethan, Basile Njei, Xiang Zhu, Kiran Kommaraju, Mansour A Parsi, Shyam Varadarajulu
Background and aims Given the limited data on the safety of endoscopic retrograde cholangiopancreatography (ERCP) in patients with liver cirrhosis, we attempted to evaluate this question using a large national database. Methods We conducted a matched case - control study using the 2010 National Inpatient Sample database in which four non-cirrhotic controls were matched randomly for every cirrhotic patient from the same 10-year age group. We compared adverse events and safety of inpatient ERCP between patients with (n = 3228) and without liver cirrhosis (controls, n = 12 912)...
April 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28375865/aggressive-hydration-for-the-prevention-of-post-ercp-pancreatitis-effective-when-combined-with-rectal-nsaids
#11
Xavier J N M Smeets, Joost P H Drenth, Erwin J M van Geenen
No abstract text is available yet for this article.
April 3, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28374181/diclofenac-does-not-reduce-the-risk-of-post-endoscopic-retrograde-cholangiopancreatography-pancreatitis-in-low-risk-units
#12
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/28337485/safety-and-efficacy-of-minimal-biliary-sphincterotomy-with-papillary-balloon-dilation-m-ebs-epbd-in-patients-using-clopidogrel-or-anticoagulation
#13
Shaffer R S Mok, Murtaza Arif, David L Diehl, Harshit S Khara, Henry C Ho, Adam B Elfant
Background and study aims Endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic biliary sphincterotomy (EBS) or endoscopic papillary balloon dilation (EPBD) are common techniques of biliary decompression. Potential risks include gastrointestinal hemorrhage, which can be increased by antiplatelet agents, anticoagulants (AC) and/or novel oral anticoagulants (NOACs) (ie. apixaban, dabigatran and rivaroxaban). The study aim is to evaluate the safety/efficacy of an alternative technique, minimal-EBS plus EPBD (m-EBS + EPBD), in individuals for whom clopidogrel, AC, and/or NOACs cannot be interrupted due to high cardiovascular or thromboembolic risk...
March 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28337482/efficacy-and-safety-of-novel-digital-single-operator-peroral-cholangioscopy-guided-laser-lithotripsy-for-complicated-biliary-stones
#14
John Ct Wong, Raymond Sy Tang, Anthony Yb Teoh, Joseph Jy Sung, James Yw Lau
Background/study aims Laser lithotripsy can effectively fragment complicated biliary stones, but current cholangioscopes are limited by fragility, restricted mobility or moderate visual resolution. The efficacy and safety of a new digital single-operator peroral cholangioscope to guide laser lithotripsy were evaluated. Patients and methods In this prospective single-center series, consecutive patients with complicated biliary stones, defined as impacted stones > 1.5 cm in size and wider than the more distal common bile duct, or stones that failed extraction by basket mechanical lithotripsy, underwent ERCP and SpyGlass DS peroral cholangioscope (Boston Scientific, Marlborough, United States)-guided laser lithotripsy...
January 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28336200/systematic-review-of-transgastric-ercp-in-roux-en-y-gastric-bypass-patients
#15
Nikhil Banerjee, Mayur Parepally, T Karl Byrne, Rana C Pullatt, Gregory A Coté, B Joseph Elmunzer
Balloon-assisted endoscopic retrograde cholangiopancreatoscopy (ERCP) in Roux-en-Y gastric bypass (RYGB) patients is technically challenging due to anatomic and accessory constraints, thus success rates are modest. Transgastric ERCP (TG-ERCP) offers a viable alternative. We aimed to systematically review the literature on TG-ERCP in RYGB patients to better define the technical approaches, success rates, and adverse events of this procedure. A computer-assisted search of the Embase and PubMed databases was performed to identify studies that focused on the techniques and clinical outcomes of TG-ERCP...
February 10, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28321164/efficacy-and-safety-of-limited-endoscopic-sphincterotomy-before-self-expandable-metal-stent-insertion-for-malignant-biliary-obstruction
#16
Hyeong Seok Nam, Dae Hwan Kang, Hyung Wook Kim, Cheol Woong Choi, Su Bum Park, Su Jin Kim, Dae Gon Ryu
AIM: To evaluate the safety and efficacy of limited endoscopic sphincterotomy (ES) before placement of self-expandable metal stent (SEMS). METHODS: This was a retrospective analysis of 244 consecutive patients with unresectable malignant biliary obstruction, who underwent placement of SEMSs following limited ES from December 2008 to February 2015. The diagnosis of malignant biliary obstruction and assessment of patient eligibility for the study was established by a combination of clinical findings, laboratory investigations, imaging and pathological results...
March 7, 2017: World Journal of Gastroenterology: WJG
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
#17
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
#18
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/28209101/role-of-heart-rate-variability-in-predicting-post-endoscopic-retrograde-cholangiopancreatography-pancreatitis
#19
Y Tryliskyy, G J Bryce
INTRODUCTION: Early recognition of post-ERCP pancreatitis (PEP) would help deliver an appropriate discharge plan following ERCP. Functioning of the autonomic nervous system can be measured using non-invasive heart rate variability techniques (HRV) and provides quantitative information about the modulation of cardiac vagal and sympathetic activity. Pain evoked sympathetic activation is a well-known phenomenon, as exhibited in those suffering PEP. The aim of this study is to determine if a single post-procedural measurement of HRV identifies those at risk of developing PEP...
September 2016: Acta Gastro-enterologica Belgica
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
#20
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
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