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post-ERCP pancreatitis

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https://www.readbyqxmd.com/read/28209101/role-of-heart-rate-variability-in-predicting-post-endoscopic-retrograde-cholangiopancreatography-pancreatitis
#1
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
#2
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/28185468/post-ercp-pancreatitis-early-precut-or-pancreatic-duct-stent-a-multicenter-randomized-controlled-trial-and-cost-effectiveness-analysis
#3
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/28178088/aggressive-hydration-with-lactated-ringer-solution-in-prevention-of-postendoscopic-retrograde-cholangiopancreatography-pancreatitis-a-meta-analysis-of-randomized-controlled-trials
#4
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/28173939/outcome-and-management-of-endoscopic-retrograde-cholangiopancreatography-perforations-a-community-perspective
#5
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
#6
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
#7
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
https://www.readbyqxmd.com/read/28160947/the-scope-of-post-ercp-pancreatitis
#8
REVIEW
Parth J Parekh, Raj Majithia, Sanjay K Sikka, Todd H Baron
Pancreatitis is the most common adverse event of endoscopic retrograde cholangiopancreatography, with the potential for clinically significant morbidity and mortality. Several patient and procedural risk factors have been identified that increase the risk of post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP). Considerable research efforts have identified several pharmacologic and procedural interventions that can drastically affect the incidence of PEP. This review article addresses the underlying mechanisms at play for the development of PEP, identifying patient and procedural risk factors and meaningful use of risk-stratification information, and details current interventions aimed at reducing the risk of this complication...
February 1, 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28112449/reply-to-letter-to-the-editor-of-digestive-endoscopy
#9
Yunlu Feng, Xiang Zhu, Yang Aiming
We are grateful for the opportunity to respond to the letter to the editor entitled "Is rectal indomethacin ineffective in the prevention of post-ERCP pancreatitis in general population" by Shen et al(1) through this erratum. We have realized that there were some errors in our paper(2) and have adjusted part of the description of statistical analysis as follows: "Meta-analysis was performed by calculating pooled odds ratios. Random effect models and DerSimonian-Laird weights were used to estimate pooled ORs and their 95% CI...
January 23, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28112441/rectal-nsaids-in-the-prevention-of-post-ercp-pancreatitis-in-unselected-patients-a-systematic-review-and-meta-analysis
#10
REVIEW
Chongrong Shen, Yanqiang Shi, Tianyu Liang, Peizhu Su
BACKGROUND: The efficacy of rectal nonsteroidal anti-inflammatory drugs (NSAIDs) for post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) prophylaxis in unselected patients is controversial. AIM: To evaluate the efficacy of rectal NSAIDs in the prevention of PEP in unselected patients. METHODS: An electronic literature search in the Cochrane library, Embase, and PubMed was performed for randomized controlled trials comparing rectal indomethacin or diclofenac with placebo in the prevention of PEP in unselected patients...
January 23, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28093301/protocol-driven-management-of-suspected-common-duct-stones
#11
Anthony Manning, Richard Frazee, Stephen Abernathy, Claire Isbell, Travis Isbell, Justin Regner, Yolanda Munoz-Maldonado, Randall Smith
BACKGROUND: Common duct stones can be diagnosed by magnetic resonance cholangiopancreatography (MRCP), endoscopic ultrasound (EUS)/ERCP, and intraoperative cholangiogram (IOC). In 2015, our group adopted a standard approach of preoperative EUS/ERCP followed by laparoscopic cholecystectomy for patients with an admission bilirubin >4.0 mg/dL. For bilirubin <4.0 mg/dL, laparoscopic cholecystectomy with IOC was the initial procedure. Postoperative EUS/ERCP with endoscopic sphincterotomy was pursued for positive IOC...
January 16, 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
#12
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
#13
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
#14
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%C3%A2-pancreatitis
#15
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 (CP), and the concept that 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: In this observational cohort study, medical records of patients with CP (CP group) and biliary diseases (BD group) in a tertiary hospital from January 2011 to May 2015 were examined...
January 4, 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
#16
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
#17
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
#18
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
#19
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
#20
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
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