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post-ERCP pancreatitis

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https://www.readbyqxmd.com/read/27924097/editorial-guidewire-trauma-a-key-component-of-post-ercp-pancreatitis-that-is-best-controlled-by-the-endoscopist
#1
Indu Srinivasan, Martin L Freeman
Recent studies have revealed that deep pancreatic duct wire passage, even in the absence of contrast injection, is a major technique-related culprit in post-ERCP pancreatitis, unless followed by placement of a pancreatic stent. As guidewire cannulation becomes increasingly widespread, precise control of the guidewire is thus critical. The first randomized trial to compare endoscopist-controlled wire guided vs. assistant-controlled bile duct cannulation has shown a significant reduction in post ERCP pancreatitis when the physician manipulates the wire...
December 2016: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/27914176/prophylactic-rectal-indomethacin-may-be-ineffective-for-preventing-post-ercp-pancreatitis-in-general-patients-a-meta-analysis
#2
REVIEW
Yunlu Feng, Udayakumar Navaneethan, Xiang Zhu, Shyam Varadarajulu, Ingrid Schwartz, Robert H Hawes, Muhammad K Hasan, Aiming Yang
BACKGROUND AND AIMS: The efficacy of prophylactic indomethacin for prevention of post-ERCP pancreatitis (PEP) in general patients remains controversial. To address this, we therefore conducted a meta-analysis of clinical trials specifically on rectal indomethacin in prevention of PEP in consecutive patients undergoing ERCP. METHODS: We searched MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials databases to identify randomized, double-blinded, controlled clinical trials on rectal indomethacin in prevention of PEP in consecutive patients undergoing ERCP...
December 3, 2016: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/27909551/post-endoscopic-retrograde-cholangiopancreatography-pancreatitis-risk-factors-and-predictors-of-severity
#3
Ayman El Nakeeb, Ehab El Hanafy, Tarek Salah, Ehab Atef, Hosam Hamed, Ahmad M Sultan, Emad Hamdy, Mohamed Said, Ahmed A El Geidie, Tharwat Kandil, Mohamed El Shobari, Gamal El Ebidy
AIM: To detect risk factors for post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) and investigate the predictors of its severity. METHODS: This is a prospective cohort study of all patients who underwent ERCP. Pre-ERCP data, intraoperative data, and post-ERCP data were collected. RESULTS: The study population consisted of 996 patients. Their mean age at presentation was 58.42 (± 14.72) years, and there were 454 male and 442 female patients...
November 16, 2016: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27905178/follow-up-to-determine-unplanned-hospitalization-and-complications-after-endoscopic-retrograde-cholangiopancreatography
#4
Edwina Chan, Teresa Neeman, Andrew Thomson
BACKGROUND: Studies of endoscopic retrograde cholangiopancreatography (ERCP)-related complications are inconsistent and sometimes have insufficient patient follow-up. The aim of this study was to investigate risk factors for ERCP-related events, leading to hospitalization in the case of outpatients and prolonged hospital stay in the case of inpatients, using assiduous follow-up and contemporaneous recording of data. METHODS: Prospectively collected data of 1000 consecutive ERCP procedures performed by a single endoscopist at a tertiary referral centre in Canberra, Australia, were studied and the complications evaluated...
December 1, 2016: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/27888858/novel-findings-in-the-management-of-acute-pancreatitis
#5
Federico Bolado, Enrique de-Madaria
Acute pancreatitis (AP) is a potentially serious disease whose incidence is on the increase. Pancreas divisum does not meet the required criteria to be considered an aetiological factor. Sphincter of Oddi dysfunction may be another cause of idiopathic AP. Less invasive methods cannot replace Sphincter of Oddi manometry in diagnosis. Almost half of patients with systemic inflammatory response syndrome develop organ failure, but the mechanisms involved are not completely understood. Obesity is a risk factor for severity in AP; the cause could be the presence of free unsaturated fatty acids, which have pro-inflammatory activity...
September 2016: Gastroenterología y Hepatología
https://www.readbyqxmd.com/read/27849643/comparison-of-rectal-indomethacin-diclofenac-and-naproxen-for-the-prevention-of-post-endoscopic-retrograde-cholangiopancreatography-pancreatitis
#6
Amir H Mohammad Alizadeh, Mohammad Abbasinazari, Behzad Hatami, Saeed Abdi, Forozan Ahmadpour, Shideh Dabir, Aida Nematollahi, Samira Fatehi, Mohammad A Pourhoseingholi
BACKGROUND AND AIM: NSAIDs are commonly utilized for the prevention of post endoscopic retrograde cholangiopancreatography pancreatitis (PEP). However, not much is known about the most effective drug in preventing this complication. This study aims to clarify which drug (indomethacin, diclofenac, or naproxen) is most effective for the prevention of post endoscopic retrograde cholangiopancreatography (ERCP). MATERIALS AND METHODS: In a double-blind, randomized study, patients received a single rectal dose of one of the three drugs 30 min before undergoing ERCP: diclofenac (100 mg), indomethacin (100 mg), or naproxen (500 mg)...
November 15, 2016: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27816497/lactated-ringer-s-solution-in-combination-with-rectal-indomethacin-for-prevention-of-post-ercp-pancreatitis-and-readmission-a-prospective-randomized-double-blinded-placebo-controlled-trial
#7
Shaffer R S Mok, Henry C Ho, Paurush Shah, Milan Patel, John P Gaughan, Adam B Elfant
BACKGROUND AND AIMS: Prospective data have shown the benefit of rectal indomethacin (IND) for preventing post-ERCP pancreatitis (PEP). A recent pilot study demonstrated a lower incidence of PEP after an 8-hour lactated ringer's (LR) infusion. The aim of this study was to evaluate the efficacy of IND with or without bolus LR in patients at high-risk for PEP. METHODS: In this randomized, double-blinded, placebo-controlled trial we assigned patients to standard normal saline solution (NS)+placebo, NS+IND, LR+placebo or LR+IND...
November 2, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27812520/efficacy-and-safety-of-endoscopic-papillary-large-balloon-dilation-for-removal-of-large-bile-duct-stones-in-advanced-age
#8
Kook Hyun Kim, Tae Nyeun Kim
Objective. Bile duct stone-related adverse events can be detrimental in the elderly. However, little is known about clinical outcomes and adverse events following endoscopic papillary large balloon dilation (EPLBD) in the elderly. The aim of this study was to evaluate the safety and feasibility of EPLBD for the removal of CBD stones in patients aged ≥ 80 years. Methods. A total of 204 patients who underwent EPLBD from 2006 to 2012 were retrospectively reviewed. Patients were classified into two groups (148 patients < 80 years old, Group A; 56 patients ≥ 80 years old, Group B)...
2016: Canadian Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27801342/-the-efficiency-of-different-biliary-cannulation-in-endoscopic-retrograde-cholangiopancreatography-a-meta-analysis
#9
Q Ma, Y D Yao, X X Hou, M C Wang, Z G Wei, J H Tian, Y C Zhang, X D He
Objective: To compare the success rates of wire-guided biliary cannulation (WGC) and conventional cannulation (CC) and their effect on the outcome of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP). Methods: All randomized controlled trials (RCTs) were collected by searching CNKI, WanFang Data, CBM, PubMed, Embase and Cochrane Library.The assessment of methodological quality and data extraction of the included studies were performed independently by two reviewers. Meta-analysis was conducted with RevMan 5...
November 1, 2016: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/27785324/role-of-rectal-diclofenac-suppository-for-prevention-and-its-impact-on-severity-of-post-endoscopic-retrograde-cholangiopancreatography-pancreatitis-in-high-risk-patients
#10
Sandeep Patil, Vikas Pandey, Nilesh Pandav, Meghraj Ingle, Aniruddha Phadke, Prabha Sawant
BACKGROUND: The aim was to study the role of rectal diclofenac in prevention of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis and its impact on severity of post-ERCP pancreatitis. METHODS: We conducted a single-center, prospective, open-labeled, randomized trial for evaluating the use of rectal diclofenac in prevention of post-ERCP pancreatitis in high-risk patients. We assessed 526 patients coming for ERCP for different indications. Four hundred patients were eligible for the study...
June 2016: Gastroenterology Research
https://www.readbyqxmd.com/read/27777436/a-multicenter-prospective-randomized-controlled-trial-evaluating-the-efficacy-of-rectal-diclofenac-and-sublingual-nitroglycerin-as-a-combined-prophylactic-treatment-for-post-ercp-pancreatitis
#11
Takeshi Tomoda, Hironari Kato, Sho Mizukawa, Shinichiro Muro, Yutaka Akimoto, Daisuke Uchida, Kazuyuki Matsumoto, Naoki Yamamoto, Shigeru Horiguchi, Koichiro Tsutsumi, Hiroyuki Okada
Acute pancreatitis is the major complication of endoscopic retrograde cholangiopancreatography (ERCP). A preliminary research suggested that the administration of nonsteroidal anti-inflammatory drugs (NSAIDs) with nitroglycerin might reduce the incidence of post-ERCP pancreatitis (PEP) more effectively than NSAIDs alone. We conduct a two-arm, multicenter, prospective, randomized, superiority trial to evaluate the additional effect of nitroglycerin for prevention of PEP. A total of 900 patients randomly receive 50 mg diclofenac suppository either alone or with 5 mg isosorbide dinitrate sublingual tablet...
2016: Acta Medica Okayama
https://www.readbyqxmd.com/read/27756613/pancreatic-juice-cytology-with-immunohistochemistry-to-detect-malignancy-and-histological-subtypes-in-patients-with-branch-duct-type-intraductal-papillary-mucinous-neoplasms-of-the-pancreas
#12
Shinsuke Koshita, Yutaka Noda, Kei Ito, Yoshihide Kanno, Takahisa Ogawa, Kaori Masu, Yoshiharu Masaki, Jun Horaguchi, Masaya Oikawa, Takashi Tsuchiya, Takashi Sawai, Miwa Uzuki, Fumiyoshi Fujishima
BACKGROUND AND AIMS: To elucidate the efficacy of pancreatic juice cytology with the cell block method (CB-PJC) for the determination of surgery in patients with branch duct intraductal papillary mucinous neoplasm (BD-IPMN). METHODS: In 138 patients with BD-IPMN from whom pancreatic juice was collected under ERCP for CB-PJC, we retrospectively evaluated the following: (1) the rate of the CB-PJC successfully evaluated, (2) the ability of CB-PJC for the diagnosis of malignant BD-IPMNs and for the identification of pathological subtypes in resected BD-IPMNs, (3) the rate of development into invasive cancer and progression of BD-IPMNs in patients with BD-IPMN diagnosed as benignancy by CB-PJC, and (4) post-ERCP adverse events...
October 15, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27747287/use-of-double-wire-guided-technique-and-transpancreatic-papillary-septotomy-in-difficult-ercp-4-year-experience
#13
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
https://www.readbyqxmd.com/read/27747282/intravenous-injection-of-low-dose-flurbiprofen-axetil-for-preventing-post-ercp-pancreatitis-in-high-risk-patients-an-interim-analysis-of-the-trial
#14
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
https://www.readbyqxmd.com/read/27729744/efficacy-and-safety-of-emergency-endoscopic-retrograde-cholangiopancreatography-for-acute-cholangitis-in-the-elderly
#15
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
https://www.readbyqxmd.com/read/27708522/anesthesia-for-endoscopic-retrograde-cholangiopancreatography-target-controlled-infusion-versus-standard-volatile-anesthesia
#16
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
https://www.readbyqxmd.com/read/27693329/nonsteroidal-anti-inflammatory-drugs-for-prevention-of-post-ercp-pancreatitis-sooner-rather-than-later-during-ercp
#17
Gregory A Coté, B Joseph Elmunzer
No abstract text is available yet for this article.
September 29, 2016: Gastroenterology
https://www.readbyqxmd.com/read/27690682/impact-of-nitroglycerin-and-glucagon-administration-on-selective-common-bile-duct-cannulation-and-prevention-of-post-ercp-pancreatitis
#18
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
https://www.readbyqxmd.com/read/27676699/how-does-aging-affect-presentation-and-management-of-biliary-stones
#19
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...
November 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27669472/repeated-cannulation-attempts-or-late-precut-which-is-more-risky-for-post-ercp-pancreatitis
#20
A Emre Yildirim, Abdurrahman Kadayifci
No abstract text is available yet for this article.
October 2016: Endoscopy
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