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https://www.readbyqxmd.com/read/28230608/specialized-imaging-and-procedures-in-pediatric-pancreatology-a-north-american-society-for-pediatric-gastroenterology-hepatology-and-nutrition-clinical-report
#1
Tom K Lin, David M Troendle, Daniel B Wallihan, Bradley Barth, Victor L Fox, Douglas S Fishman, Veronique D Morinville
OBJECTIVES: An increasing number of children are being diagnosed with pancreatitis and other pancreatic abnormalities. Dissemination of the information regarding existing imaging techniques and endoscopic modalities to diagnose and manage pancreatic disorders in children is sorely needed. METHODS: We conducted a review of the medical literature on the use of the following imaging and procedural modalities in pediatric pancreatology: transabdominal ultrasonography (TUS), computed tomography (CT), magnetic resonance imaging (MRI)/magnetic resonance cholangiopancreatography (MRCP), endoscopic ultrasonography (EUS), and endoscopic retrograde cholangiopancreatography (ERCP)...
March 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28229615/bacteremia-with-raoultella-planticola-in-the-setting-of-acute-pancreatitis-complicated-with-acute-cholangitis
#2
Esther Merino Rodríguez, Susana Rebolledo Olmedo, Joaquín Miquel Plaza
The bacterium Raoultella planticola (R planticola) is a rare pathogen in humans. We report a case of mild acute pancreatitis (MAP) of biliary origin with cholangitis and bacteremia with R planticola in association with pancreatic panniculitis (PP). A 55-year-old woman with rheumatic multiple valvulopathy presented with epigastric pain radiating to the back in a belt-like fashion for 48 hours, jaundice, choluria, acholia, and fever (38.2oC). Lab tests showed: amylase 2126 U/L, ALT 124 U/L, AST 169 U/L, GGT 3548 U/L, AP 1516 U/L, TBil 12...
February 23, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28224034/biliary-mucinous-cystic-neoplasm-a-case-report-and-review-of-the-literature
#3
Mohammad Taghi Safari, Shabnam Shahrokh, Mohammad Bagher Miri, Forough Foroughi, Amir Sadeghi
Hepatobiliary cystadenomas (HBC) is a rare neoplasm which comprising less than one percent of liver cystic neoplasms. Although it's known as a benign tumor, but they have a potential for neoplastic transformation. Making a proper diagnosis and ruling out of other differential diagnosis is important because of different treatment. In the present study, we described a case of HBC manifested as idiopathic dominant biliary stricture in common hepatic duct (CHD), on the basis of spiral CT scan and MRI, and elevated CA19-9...
December 2016: Gastroenterology and Hepatology From Bed to Bench
https://www.readbyqxmd.com/read/28220692/diagnostic-approach-using-ercp-guided-transpapillary-forceps-biopsy-or-eus-guided-fine-needle-aspiration-biopsy-according-to-the-nature-of-stricture-segment-for-patients-with-suspected-malignant-biliary-stricture
#4
Yun Nah Lee, Jong Ho Moon, Hyun Jong Choi, Hee Kyung Kim, Seo-Youn Choi, Moon Han Choi, Tae Hee Lee, Tae Hoon Lee, Sang-Woo Cha, Sang-Heum Park
In malignant biliary stricture (MBS), the diagnostic accuracy of ERCP-based tissue sampling is insufficient. EUS-guided fine needle aspiration biopsy (EUS-FNAB) is emerging as a reliable diagnostic procedure. This study aimed to evaluate the usefulness of a diagnostic approach using ERCP-guided transpapillary forceps biopsy (TPB) or EUS-FNAB according to the characteristics of suspected MBS. Consecutive patients diagnosed with suspected MBS with obstructive jaundice and/or cholangitis were enrolled prospectively...
February 21, 2017: Cancer Medicine
https://www.readbyqxmd.com/read/28215097/what-is-the-most-cost-effective-method-for-a-difficult-biliary-cannulation-in-ercp
#5
Jesús García-Cano
Editorial dealing with difficult biliary cannulation in ERCP. Pancreatic techniques that take advantage of a guidewire inserted in the Main Pancreatic Duct are preferred to needle-knife precut.
February 20, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28209101/role-of-heart-rate-variability-in-predicting-post-endoscopic-retrograde-cholangiopancreatography-pancreatitis
#6
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/28208000/two-cases-of-plug-or-stone-in-remnant-intrapancreatic-choledochal-cysts-treated-with-endoscopic-retrograde-cholangiopancreatography
#7
Eunbee Kim, Min Ho Kang, Jisun Lee, Hanlim Choi, Jae-Woon Choi, Joung-Ho Han, Seon Mee Park
Incomplete resection of choledochal cysts (CCs) that extend deep into the pancreas can lead to protein plug or stone formation, pancreatitis, and cholangiocarcinoma. We encountered two cases of choledocholithiasis in remnant intrapancreatic CCs (IPCCs), in which the patients exhibited symptoms after 3 and 21 years of cyst excision. A 21-year-old woman who had undergone excision of a CC, as a neonate, presented with epigastric pain. Abdominal computed tomography (CT) revealed stones inside the remnant pancreatic cyst, which were removed by endoscopic retrograde cholangiopancreatography (ERCP), and her symptoms improved...
February 16, 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/28207747/chronic-pancreatitis-multicentre-prospective-data-collection-and-analysis-by-the-hungarian-pancreatic-study-group
#8
Ákos Szücs, Tamás Marjai, Andrea Szentesi, Nelli Farkas, Andrea Párniczky, György Nagy, Balázs Kui, Tamás Takács, László Czakó, Zoltán Szepes, Balázs Csaba Németh, Áron Vincze, Gabriella Pár, Imre Szabó, Patrícia Sarlós, Anita Illés, Szilárd Gódi, Ferenc Izbéki, Judit Gervain, Adrienn Halász, Gyula Farkas, László Leindler, Dezső Kelemen, Róbert Papp, Richárd Szmola, Márta Varga, József Hamvas, János Novák, Barnabás Bod, Miklós Sahin-Tóth, Péter Hegyi
INTRODUCTION: Chronic pancreatitis is an inflammatory disease associated with structural and functional damage to the pancreas, causing pain, maldigestion and weight loss and thus worsening the quality of life. AIMS AND METHODS: Our aim was to find correlations from a multicentre database representing the epidemiological traits, diagnosis and treatment of the disease in Hungary. The Hungarian Pancreatic Study Group collected data prospectively from 2012 to 2014 on patients suffering from chronic pancreatitis...
2017: PloS One
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
#9
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
https://www.readbyqxmd.com/read/28188033/success-and-safety-of-endoscopic-retrograde-cholangiopancreatography-in-children
#10
Jordan D Rosen, Rebecca S Lane, Jose M Martinez, Eduardo A Perez, Jun Tashiro, Amy E Wagenaar, Robert M Van Haren, Ashwini Kumar, Juan E Sola
PURPOSE: Despite its diagnostic and therapeutic utility, endoscopic retrograde cholangiopancreatography (ERCP) is underutilized in children. METHODS: Patients younger than 18years undergoing ERCP from 2000 to 2014 at a children's hospital were identified. Patient characteristics and outcomes were evaluated. RESULTS: Overall, 215 ERCPs (78% therapeutic) were performed in 184 patients. Our cohort was 67% female, with a median age (IQR) of 14 (8) years...
February 1, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28185468/post-ercp-pancreatitis-early-precut-or-pancreatic-duct-stent-a-multicenter-randomized-controlled-trial-and-cost-effectiveness-analysis
#11
Hui Jer Hwang, Martín Alejandro Guidi, Cecilia Curvale, Juan Lasa, Raúl Matano
BACKGROUND: Pancreatitis is the most frequent complication due to ERCP. Pancreatic duct stent placement has been described as a preventive measure. There is also evidence pointing towards the preventive effect that early precut may provide. AIM: To determine and compare the cost-effectiveness of an early precut approach versus pancreatic duct stent placement for the prevention of post-ERCP pancreatitis. METHODS: This was a multicenter, randomized-controlled pilot study with a cost-effectiveness analysis performed between early precut (group A) and pancreatic duct stent (group B) for the prevention of pancreatitis in high-risk patients...
February 10, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28183551/cerebral-air-embolism-after-ercp
#12
Sonia Trabanco, Sara Pardo, Mónica Williams, Javier Diaz, Cristina Ruiz
Digestive endoscopic procedures have become increasingly common diagnostic and therapeutic procedures in hospitals. Generally they are safe procedures and complications, though infrequent, can occur and are potentially lethal. As the number of procedures performed increases, the complications arising are likely to become more frequent, so it is advisable to bear this in mind when establishing early diagnosis and treatment. Cerebral air embolism is a rare complication after a digestive endoscopic procedure, although in the case of endoscopic retrograde cholangiopancreatography (ERCP), may be as high as 10%...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28182359/fluorescence-in-situ-hybridization-with-the-urovysion-kit-for-the-detection-of-biliary-cancer-in-chinese-patients
#13
Xi Wu, Xuan Zeng, Aiming Yang, Fang Yao, Tao Guo, Dongsheng Wu, Shafei Wu, Hongmei Qiu, Weixun Zhou, Zhen Huo, Xinghua Lu, Jiaming Qian
BACKGROUND: Conventional biliary brush via ERCP has low clinical detection for biliary malignancy. Therefore, new approaches are needed to facilitate diagnosis. We therefore explored the application of fluorescent in situ hybrization (FISH) using a UroVysion kit for the detection of malignancy in the bile duct. METHODS: Genetic alterations of target chromosomes such as aneuploidy in Chinese biliary cancer cell lines and tissues were measured using a UroVysion kit...
February 1, 2017: Clinical Laboratory
https://www.readbyqxmd.com/read/28181706/efficacy-of-midazolam-versus-propofol-based-sedations-by-non-anesthesiologists-during-therapeutic-endoscopic-retrograde-cholangiopancreatography-in-elderly-patients-over-80-years
#14
Su Jung Han, Tae Hoon Lee, Sang-Heum Park, Young Sin Cho, Yun Nah Lee, Yunho Jung, Hyun Jong Choi, Il-Kwun Chung, Sang-Woo Cha, Jong Ho Moon, Young Deok Cho, Sun-Joo Kim
BACKGROUND: As society ages, the need for ERCP is increasing. This prospective comparative study evaluated the safety and efficacy of midazolam- versus propofol-based sedations by non-anesthesiologists during therapeutic ERCP in patients over 80 years of age. METHODS: A total of 100 patients over 80 years of age who required therapeutic ERCP were enrolled and randomly received midazolam + fentanyl (MF group) or propofol + fentanyl (PF group) sedation. Endoscopic sedation was titrated to a moderate level and performed by trained registered nurses...
February 9, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28181704/evaluation-of-the-safety-of-endoscopic-radiofrequency-ablation-for-malignant-biliary-stricture-using-a-digital-peroral-cholangioscope-with-videos
#15
Takeshi Ogura, Saori Onda, Tastsushi Sano, Wataru Takagi, Astushi Okuda, Akira Miyano, Nobu Nishioka, Miyuki Imanishi, Mio Amano, Daisuke Masuda, Kazuhide Higuchi
OBJECTIVES: The clinical impact of catheter based radiofrequency ablation (RFA) under ERCP guidance has been recently reported, however severe adverse events have also been noted. If tumor is not present in the biliary tract, severe adverse events such as perforation or bleeding due to vessel injury around the biliary tract may occur. In addition, the effectiveness of RFA may not be sufficient based solely on radiographic guidance. The aim of this study was to evaluate the actual feasibility of intraductal RFA by peroral cholangioscope (POCS) evaluation before/after RFA...
February 9, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28178088/aggressive-hydration-with-lactated-ringer-solution-in-prevention-of-postendoscopic-retrograde-cholangiopancreatography-pancreatitis-a-meta-analysis-of-randomized-controlled-trials
#16
Zhi-Feng Zhang, Zhi-Jun Duan, Li-Xia Wang, Gang Zhao, Wu-Guo Deng
BACKGROUND: Pancreatitis is the most common complication of endoscopic retrograde cholangiopancreatography (ERCP). The results of previous studies evaluating aggressive hydration with lactated Ringer solution for reducing the incidence of post-ERCP pancreatitis (PEP) are inconsistent. AIM: We performed a meta-analysis to determine whether aggressive hydration with lactated Ringer solution reduced PEP. METHODS: Randomized controlled trials (RCTs) comparing aggressive hydration with standard hydration with the same lactated Ringer solution for prophylaxis of PEP were searched in PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and CINAHL databases...
March 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28174126/accuracy-of-asge-high-risk-criteria-in-evaluation-of-patients-with-suspected-common-bile-duct-stones
#17
Huiqin He, Chenfei Tan, Jiaguo Wu, Ning Dai, Weiling Hu, Yawen Zhang, Loren Laine, James Scheiman, John J Kim
BACKGROUND AND AIMS: Endoscopic retrograde cholangiopancreatography (ERCP) is recommended for patients considered high-risk for choledocholithiasis after biochemical testing and abdominal ultrasound. Our aim was to determine whether American Society for Gastrointestinal Endoscopy (ASGE) guidelines accurately select patients where the risk of ERCP is justified. METHODS: Consecutive patients hospitalized with suspected choledocholithiasis at Sir Run Run Shaw Hospital who received biochemical testing, abdominal ultrasound, and definitive testing for choledocholithiasis (magnetic resonance cholangiopancreatography (MRCP), endoscopic ultrasound (EUS), ERCP, intraoperative cholangiogram (IOC), common bile duct (CBD) exploration) were identified...
February 4, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28173939/outcome-and-management-of-endoscopic-retrograde-cholangiopancreatography-perforations-a-community-perspective
#18
Mallory S Bray, Andrew J Borgert, Milan E Folkers, Shanu N Kothari
BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) carries a small but significant risk of perforation. Recent data suggest that select patients can be managed non-operatively. We sought to evaluate the management of ERCP perforations at our community medical center. METHODS: ERCPs performed from 2004 to 2015 were reviewed. RESULTS: Twenty-one of 2423 patients who underwent ERCP had a perforation (0.9%). ERCP procedures included balloon sweep with/without sphincterotomy and pancreatic duct stent (71%), common bile duct brushing (10%), and pancreatic duct stenting (5%)...
January 30, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28171691/toward-routine-use-of-nonsteroidal-anti-inflammatory-drugs-for-patients-undergoing-endoscopic-retrograde-cholangiopancreatography
#19
EDITORIAL
Tsuyoshi Hamada, Yousuke Nakai, Hiroyuki Isayama, Kazuhiko Koike
Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most widely used pharmacological prevention strategy for post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP).(1,2) Experimental data suggest that NSAIDs, a group of inhibitors of PTGS1 (cyclooxygenase-1 or COX-1) and PTGS2 (cyclooxygenase-2 or COX-2), can prevent PEP through inhibition of phospholipase A2 which plays a key role in triggering inflammatory response in the pancreas.(3) Given accumulating evidence from clinical trials, peri-procedural use of rectal NSAIDs is considered as an established strategy for prevention of PEP, at least for patients who have risk factors for PEP including younger age, suspected sphincter of Oddi dysfunction as an indication, and a history of pancreatitis...
February 7, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28167118/indomethacin-and-diclofenac-in-the-prevention-of-post-ercp-pancreatitis-a-systematic-review-and-meta-analysis-of-prospective-controlled-trials
#20
REVIEW
Árpád Patai, Norbert Solymosi, László Mohácsi, Árpád V Patai
BACKGROUND AND AIMS: Diclofenac and indomethacin are the most studied drugs for preventing post-ERCP pancreatitis (PEP). However, there are no prospective, randomized multicenter trials with sufficient number of patients for the correct evaluation of their efficacy. Our aim was to evaluate of all trials published in full text and studied efficacy of diclofenac or indomethacin prospective controlled with placebo or non-treatment for the prevention of PEP in adult patients undergoing ERCP...
February 3, 2017: Gastrointestinal Endoscopy
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