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ERCP complication

Ricardo U Macías-Rodríguez, Astrid Ruiz-Margáin, Jose L Rodriguez-Garcia, Sergio Zepeda-Gómez, Aldo Torre
OBJECTIVE: Endoscopic retrograde cholangio-pancreatography (ERCP) is useful for the management of biliary tract diseases; in patients with cirrhosis, portal hypertension may increase the risk for complications from ERCP. We evaluated the outcome and risk factors related to ERCP in patients with cirrhosis and portal hypertension. PATIENTS AND METHODS: In this case-control study, 37 patients (71 procedures) with cirrhosis and portal hypertension (group 1) and 37 controls (group 2) undergoing ERCP were included...
October 14, 2016: European Journal of Gastroenterology & Hepatology
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
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
Gen Tohda, Masahiro Ohtani, Masaki Dochin
AIM: To investigate the efficacy and safety of emergency endoscopic retrograde cholangiopancreatography (ERCP) in elderly patients with acute cholangitis. METHODS: From June 2008 to May 2016, emergency ERCPs were performed in 207 cases of acute cholangitis at our institution. Patients were classified as elderly if they were aged 80 years and older (n = 102); controls were under the age of 80 years (n = 105). The patients' medical records were retrospectively reviewed for comorbidities, laboratory data, etiology of cholangitis (presence of biliary stones, biliary stricture and malignancy), details of the ERCP (therapeutic approaches, technical success rates, procedure duration), ERCP-related complications and mortality...
October 7, 2016: World Journal of Gastroenterology: WJG
Jesús A Bahena-Aponte, Guillermo Ramírez de Aguilar, Juan Carlos Torres Carrillo, Luis Espino Urbina, Jesús A Sánchez González
We present the case of a 34 years old female patient who presents with abdominal pain and elevated total and direct bilirrubins, so she underwent ERCP Reporting: a) successful sphincterotomy without complications, b) choledocholithias is endoscopically resolved, c) secondary cholangitis. She developed significant abdominal pain at 72 h, with hypovolemic shock and peritoneal irritation. She was taken to the surgery, finding a grade III liver laceration. This one was resolved with liver raffia and packing, during the same operative time cholecystectomy was performed...
July 2016: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
Jorge Espinoza-Ríos, Miluska Aliaga Ramos, Jenny Rodríguez Borda, Eduardo Miraval Wong, Arturo Zegarra Chang, Eduar Bravo Paredes, Ricardo Prochazka Zárate
OBJECTIVE: We present a descriptive analysis of our cases of sphincterotomy followed by papillary large balloon dilation in a single session (ES-LBD) in the management of difficult to extract calculi, with the objective of assessing rates of therapeutic success and complications in local experience. MATERIAL AND METHODS: ERCP procedures with ES-LBD performed for choledocholithiasis between January 2009 and December 2014 in patients older than 18 years and without preexistent sphincterotomy were selected from records of the Gastroenterology Service at Cayetano Heredia National Hospital...
July 2016: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
Sheng Wang, Wen Liu, Siyu Sun, Guoxin Wang, Xiang Liu, Nan Ge, Jintao Guo
AIM: To evaluate the use of a double-channel gastroscope in patients with Billroth II gastrectomy to perform endoscopic retrograde cholangiopancreatography (ERCP) and interventions. MATERIAL AND METHODS: From January 2008 to December 2013, 18 patients with Billroth II gastrectomy were enrolled in this study. Endoscopic retrograde cholangiopancreatography was performed using a straight forward gastroscope with double working channel (4.2-mm diameter, 2.8-mm diameter)...
2016: Przegla̜d Gastroenterologiczny
Youssef Motiaa, Mustapha Bensghir, Abdelhamid Jaafari, Mohammed Meziane, Redouane Ahtil, Noureddine Drissi Kamili
BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) is a technique used both for diagnosis and for the treatment of biliary and pancreatic diseases. ERCP has some anesthetic implications and specific complications. The primary outcome aim was to compare two protocols in terms of time of extubation. We also compared anesthetic protocols in terms of hemodynamic and respiratory instability, antispasmodics needs, endoscopist satisfaction, and recovery room stay. METHODS: Patients were randomized into two groups standard anesthesia group (Gr: SA) in whom induction was done by propofol, fentanyl and cisatracurium and maintenance was done by a mixture of oxygen, nitrousoxide (50%:50%) and sevoflurane; and intravenous anesthesia group to target concentration (Gr: TCI) in whom induction and maintenance of anesthesia were done with propofol with a target 0...
October 2016: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
Yaping Liu, Dong Wang, Zhaoshen Li
Objective. To investigate the therapeutic safety, feasibility, and efficacy of endoclips for closing the endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP) related duodenal perforation in a retrospective study from a single center. Methods. Patients who developed EUS and ERCP related duodenal perforation between January 2012 and January 2015 were included in the study. All the cases underwent endoscopic closure by endoclips, and the efficacy, feasibility, and safety of this technique were evaluated...
2016: Gastroenterology Research and Practice
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
Xiao Zheng, Bo Sun, Ye-Chen Wu, Zhi-Yuan Bo, Wei Wan, Dao-Jian Gao, Bing Hu
OBJECTIVES: The management of benign biliary stricture is challenging. Endoscopic therapy has evolved as the first-line treatment for various benign biliary strictures. However, covered self-expandable metal stents have not been approved by the United States Food and Drug Administration for the treatment of benign biliary stricture. With this goal, we conducted this systemic review and meta-analysis to evaluate the efficacy and safety of endoscopic stenting with covered self-expandable metal stent in the treatment of benign biliary stricture...
September 28, 2016: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
Kuang-Chun Hu, Cheng-Hsin Chu, Horng-Yuan Wang, Wen-Hsiung Chang, Shee-Chan Lin, Chuan-Chuan Liu, Wei-Chih Liao, Chun-Jen Liu, Ming-Shiang Wu, Shou-Chuan Shih
Common bile duct (CBD) stones are common in elderly adults, but the effect of aging on the presentation of CBD stones remains to be evaluated. Recent studies have demonstrated that the clinical presentation of CBD stones may vary with age. Younger adults may present with classical biliary colic symptoms, whereas elderly adults may have no unapparent clinical features. Younger adults with CBD stones were significantly more likely to have abnormal liver function tests than those without. The sensitivity and accuracy of transabdominal ultrasound scans in screening for CBD stones increases with age...
September 27, 2016: Journal of the American Geriatrics Society
Danielle Usatin, Melissa Fernandes, Isabel E Allen, Emily R Perito, James Ostroff, Melvin B Heyman
OBJECTIVES: To systematically review risks and summarize reported complication rates associated with the performance of endoscopic retrograde cholangiopancreatography (ERCP) in children during the past 2 decades. STUDY DESIGN: A systematic literature search of MEDLINE, Embase, and Web of Science from January 1995 to January 2016 was conducted for observational studies published in English. Studies reporting ERCP complications in patients <21 years without history of liver transplant or cholecystectomy were included...
September 20, 2016: Journal of Pediatrics
Gianfranco Donatelli, Fabrizio Cereatti, Jean-Loup Dumont, Parag Dhumane, Thierry Tuszynski, Serge Derhy, Alexandre Meduri, Bertrand Marie Vergeau, Bruno Meduri
BACKGROUND AND STUDY AIMS: Duodenal obstruction may prevent performance of endoscopic retrograde cholangiopancreatography (ERCP). Percutaneous transhepatic biliary drainage (PTBD) or Endoscopic ultrasonograhy-guided biliary access (EUS-BD) are alternative treatments but are associated with a higher morbidity and mortality rate. The aim of the study is to report overall technical success rate and clinical outcome with deployment of temporary fully or partially covered self-expanding duodenal stent (pc/fcSEMS) as a bridge to ERCP in case of inaccessible papilla due to duodenal strictures...
September 2016: Endoscopy International Open
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
Amy Tyberg, Jose Nieto, Sanjay Salgado, Kristen Weaver, Prashant Kedia, Reem Z Sharaiha, Monica Gaidhane, Michel Kahaleh
Background/Aims: Performing endoscopic retrograde cholangiopancreatography (ERCP) in patients who have undergone Rouxen-Y gastric bypass (RYGB) is challenging. Standard ERCP and enteroscopy-assisted ERCP are associated with limited success rates. Laparoscopy- or laparotomy-assisted ERCP yields improved efficacy rates, but with higher complication rates and costs. We present the first multicenter experience regarding the efficacy and safety of endoscopic ultrasound (EUS)-directed transgastric ERCP (EDGE) or EUS...
September 19, 2016: Clinical Endoscopy
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
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
Noritaka Ozawa, Ichiro Yasuda, Shinpei Doi, Takuji Iwashita, Masahito Shimizu, Tsuyoshi Mukai, Masanori Nakashima, Tesshin Ban, Issei Kojima, Koichiro Matsuda, Mitsuru Matsuda, Yusuke Ishida, Yoshinobu Okabe, Nobuhiro Ando, Keisuke Iwata
BACKGROUND: In Japan and Europe, a retrieval basket is generally used for endoscopic extraction of bile duct stones, while in the US, a retrieval balloon is mainly used. However, the efficacies of these two devices have not been previously compared. Therefore, the present multicenter, prospective, randomized study was performed to compare the efficacies of these two devices for endoscopic biliary stone extraction. METHODS: This study was designed as a non-inferiority study in comparing a basket removal with a balloon removal...
September 8, 2016: Journal of Gastroenterology
Shinichi Hashimoto, Kei Ito, Shinsuke Koshida, Yoshihide Kanno, Takahisa Ogawa, Kaori Masu, Yuji Iwashita, Jun Horaguchi, Go Kobayashi, Yutaka Noda
Objective To retrospectively evaluate the risk factors for post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) and stent dysfunction after performing preoperative biliary drainage (BD) in patients with malignant biliary stricture. Methods Between January 2003 and February 2013, 105 consecutive patients who had undergone transpapillary BD before surgery were enrolled in this study. Procedure-related complications, stent dysfunction rates, and their respective risk factors were investigated...
2016: Internal Medicine
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