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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/28633199/diffuse-type-caroli-disease-with-characteristic-central-dot-sign-complicated-by-multiple-intrahepatic-and-common-bile-duct-stones
#2
Moon Joo Hwang, Tae Nyeun Kim
Caroli disease (CD) is a rare congenital malformation of the liver characterized by non-obstructive, segmental, cystic dilatation of the intrahepatic bile ducts (IHDs). The clinical course is usually asymptomatic for the first 5-20 years, and symptoms may seldom occur throughout the patient's life. Bile stagnation leads to recurrent episodes of cholangitis, stone formation, or liver abscesses, and biliary cirrhosis usually occurs years later. Here we report on a 42-year-old man diagnosed with diffuse-type CD with a characteristic central dot sign, who had multiple intrahepatic and common bile duct (CBD) stones...
June 20, 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/28624651/efficacy-and-optimal-duration-of-metallic-stent-in-the-management-of-refractory-anastomotic-stricture-after-liver-transplantation
#3
Sunguk Jang, Mansour A Parsi, Rocio Lopez, Amit Bhatt, John J Vargo
BACKGROUND: Anastomotic bile duct stricture (ABS) remains as one of the most common complications in liver transplant patients. Current practice of endoscopic retrograde cholangiopancreatography (ERCP) with insertion of plastic stent (PS) often requires multiple procedures before achieving stricture resolution. To date, studies utilizing covered self-expandable metallic stent (cSEMS) in ABS management reported varying degree of efficacy. The aim of this study was to analyze long term efficacy of cSEMS in patients with ABS, and identifying factor(s) influencing the probability of stricture resolution...
June 14, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28624111/biliary-complications-after-liver-transplantation-recent-developments-in-etiology-diagnosis-and-endoscopic-treatment
#4
REVIEW
Floris J M Roos, Jan-Werner Poley, Wojciech G Polak, Herold J Metselaar
Biliary complications are considered to be the Achilles' heel of liver transplantation. The most common complications are leaks and bile duct strictures. Strictures can arise at the level of the anastomosis (anastomotic strictures; AS) or at other locations in the biliary tree (non-anastomotic strictures; NAS). Endoscopic treatment via endoscopic retrograde cholangiopancreatography (ERCP) is considered to be the preferred therapy for these complications. This review will focus on the diagnostic modalities, new insights in etiology of biliary complications and outcomes after different endoscopic therapies, in both deceased donor transplantation and living-donor liver transplantations...
April 2017: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/28621295/efficacy-and-safety-in-case-of-technical-success-of-endoscopic-ultrasound-guided-transhepatic-antegrade-biliary-drainage-a-report-of-a-monocentric-study
#5
Sébastien Godat, Erwan Bories, Fabrice Caillol, Christian Pesenti, Jean Philippe Ratone, Chiara de Cassan, Marc Giovannini
BACKGROUND AND OBJECTIVES: Endoscopic ultrasound (EUS)-guided biliary drainage techniques are alternative procedures in cases of obstructive jaundice with altered anatomy or failed ERCP. Complications related to EUS-guided antegrade drainage (EUS-AD) are still present in up to 10% of cases, and combination of procedures is sometimes suggested to avoid adverse events. The purpose of our study is to evaluate the efficacy and safety of EUS-AD with transhepatic access in case of technical success...
May 2017: Endoscopic Ultrasound
https://www.readbyqxmd.com/read/28617887/peroral-cholangiopancreatoscopy-with-the-spyglass%C3%A2-system-what-do-we-know-10-years-later
#6
REVIEW
Pedro Pereira, Armando Peixoto, Patrícia Andrade, Guilherme Macedo
Smaller endoscopes and catheters have been developed that permit direct visualization of the bile and pancreatic ducts (cholangioscopy and pancreatoscopy, respectively). These endoscopes and catheters are passed through the working channel of a standard therapeutic duodenoscope during endoscopic retrograde cholangiopancreatography (ERCP). The SpyGlass Direct Visualization System (Boston Scientific Corp, Natick, MA, USA) is currently the most widely used and studied device. Cholangioscopy with intraductal lithotripsy has become an established modality in the treatment of difficult biliary lithiasis...
June 2017: Journal of Gastrointestinal and Liver Diseases: JGLD
https://www.readbyqxmd.com/read/28614171/the-role-safety-steps-in-success-and-complication-rate-of-endoscopic-retrograde-cholangiopancreatography
#7
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/28611566/periorbital-ecchymosis-raccoon-eye-and-orbital-hematoma-following-endoscopic-retrograde-cholangiopancreatography
#8
Jafar Nasiri, Farhad Zamani
Endoscopic retrograde cholangiopancreatography (ERCP) is a conventional technique for diagnosis and treatment of pancratobiliary diseases, which is associated with various complications, including pancreatitis, hemorrhage, cholangitis, perforation, and mortality. In our case, a 69-year-old woman with positive hepatobiliary symptoms underwent ERCP, at the end of which a rare complication (raccoon eye) occurred, which was hypothesized to be due to amyloidosis, but the patient refused to complete the diagnostic procedure and became symptom free after 3 weeks...
January 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28611338/endoscopic-retrograde-cholangiopancreatography-with-double-balloon-enteroscope-in-patients-with-altered-gastrointestinal-anatomy-a-meta-analysis
#9
REVIEW
Xiao-Dong Shao, Xing-Shun Qi, Xiao-Zhong Guo
BACKGROUND/AIMS: The aim of this study was to evaluate the effectiveness and safety of endoscopic retrograde cholangiopancreatography with double balloon enteroscope (DBE-ERCP) in patients with altered gastrointestinal anatomy in a meta-analysis. MATERIALS AND METHODS: A comprehensive literature search was conducted on PubMed, EMBASE, and Cochrane library covering the period from January 2001 to December 2015. Data were selected and abstracted from eligible studies and were pooled using a random-effects model...
May 2017: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
https://www.readbyqxmd.com/read/28609791/transpancreatic-sphincterotomy-has-a-higher-cannulation-success-rate-than-needle-knife-precut-papillotomy-a-meta-analysis
#10
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/28603054/comparable-long-term-outcomes-of-1-minute-vs-5-minute-endoscopic-papillary-balloon-dilation-for-bile-duct-stones
#11
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/28593787/cholangitis-after-endoscopic-retrograde-cholangiopancreatography-a-rare-complication
#12
Armando Peixoto, Marco Silva, Guilherme Macedo
In our experience, post-ERCP acute cholangitis developed in approximately 5% of cases with a not negligible mortality of nearly 30% in spite of antibiotic therapy. Analytical factors can help to identify the most serious cases that could benefit from a more aggressive approach.
June 8, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28583749/predictors-for-early-readmission-in-acute-pancreatitis-ap-in-the-united-states-us-a-nationwide-population-based-study
#13
Satish Munigala, Divya Subramaniam, Dipti P Subramaniam, Paula Buchanan, Hong Xian, Thomas Burroughs, Guru Trikudanathan
BACKGROUND & AIMS: Population based data on the burden and patterns of acute pancreatitis (AP) early readmissions (≤30-days) are limited. METHODS: 2013 Nationwide Readmission Database (NRD) was queried. AP etiology was determined using associated diagnoses codes. Proportion, reasons for readmission, and associated costs were evaluated. Multivariate logistic regression analysis was performed to identify independent predictors for 30-day readmission. RESULTS: After exclusions, we identified 178,541 patients with primary diagnosis of AP (mean age 53 ± 17 years, 51% male)...
May 29, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28567453/hemobilia-due-to-arteriobiliary-fistula-complicating-ercp-for-residual-bile-duct-stone-in-a-case-of-mirizzi-syndrome
#14
Surendrakumar Mathur, Vinaykumar Thapar, Vasudev Chowda
Hemobilia is a rare cause of upper gastrointestinal tract bleeding. Most cases are iatrogenic following medical interventions, most commonly liver biopsy and transhepatic cholangiography. We present a case of arteriobiliary fistula between the right hepatic artery and the common hepatic duct, in a case of Mirrizi syndrome, following endoscopic biliary stenting and presenting with hemobilia. The patient was treated by surgical disconnection of the fistula, ligation of the right hepatic artery, and bilioenteric anastomosis...
May 2017: Annals of Hepato-Biliary-Pancreatic Surgery
https://www.readbyqxmd.com/read/28559784/splenic-injury-following-endoscopic-retrograde-cholangiopancreatography-a-case-report-and-literature-review
#15
REVIEW
Richard Lee, Alexander Huelsen, Nivene Saad, Peter Hodgkinson, Luke F Hourigan
Splenic injury following endoscopy is a rare but potentially fatal complication. While this has been found to occur more frequently after colonoscopy, splenic injury following endoscopic retrograde cholangiopancreatography (ERCP) remains highly uncommon since its first reported case in 1989. Indeed, there have been only 19 such cases reported in the English, German, and Spanish literature collectively over the past 27 years. We report on a 59-year-old woman who developed a peri-splenic haematoma diagnosed on abdominal computed tomography the day following ERCP and stenting for Mirizzi syndrome...
January 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28558658/therapeutic-outcomes-of-endoscopic-papillectomy-for-ampullary-neoplasms-retrospective-analysis-of-a-multicenter-study
#16
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
#17
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/28534552/-perforations-following-endoscopic-retrograde-cholangiopancreatography-ercp
#18
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/28515595/percutaneous-transhepatic-techniques-for-management-of-biliary-anastomotic-strictures-in-living-donor-liver-transplant-recipients
#19
Chinmay B Kulkarni, Nirmal K Prabhu, Nazar P Kader, Ramiah Rajeshkannan, Sreekumar K Pullara, Srikanth Moorthy
AIM: To retrospectively analyze the percutaneous transhepatic techniques and their outcome in the management of biliary strictures in living donor liver transplant (LDLT) recipients. MATERIALS AND METHODS: We retrieved the hospital records of 400 LDLT recipients between 2007 and 2015 and identified 45 patients with biliary strictures. Among them, 17 patients (37.8%) (Male: female = 13:4; mean age, 36.1 ± 17.5 years) treated by various percutaneous transhepatic biliary techniques alone or in combination with endoscopic retrograde cholangiopancreatography (ERCP) were included in the study...
January 2017: Indian Journal of Radiology & Imaging
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
#20
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
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