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Endoscopic retrograde cholangiopancreatography

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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/28223678/-conversion-surgery-for-initially-unresectable-locally-advanced-pancreatic-cancer-following-gemcitabine-plus-nab-paclitaxel-a-case-report
#2
Shuji Nakamoto, Ryo Nishiyama, Takayoshi Kaneda, Mitsuo Yokota, Hiroshi Kawamata, Hiroshi Tajima, Takashi Kaizu, Yusuke Kumamoto, Hiroshi Yamauchi, Kosuke Okuwaki, Tomohisa Iwai, Hiroshi Imaizumi, Erina Suzuki, Atsuko Hara, Masaaki Ichinoe, Mitsuhiro Kida, Masahiko Watanabe
We report a case of unresectable locally advanced pancreatic cancer successfully resected after gemcitabine(GEM)plus nab-paclitaxel(PTX)treatment. A 68-year-old man was referred to our institution with jaundice. We diagnosed pancreatic head cancer using computed tomography(CT)and endoscopic retrograde cholangiopancreatography. We initially diagnosed it as locally advanced unresectable pancreatic cancer because of extensive invasion to the portal vein. GEM plus nab- PTX was administered to the patient as systemic chemotherapy...
February 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28212152/an-update-on-small-bowel-endoscopy
#3
Hey-Long Ching, Mark E McAlindon, Reena Sidhu
PURPOSE OF REVIEW: The breakthrough success of capsule endoscopy and device-assisted enteroscopy has inspired researchers to test and push the boundary of these technologies. The authors herein summarize the latest and most significant studies with clinical impact. RECENT FINDINGS: Competing capsule endoscopy models have enriched the platform of this wireless device. The role of capsule endoscopy in Crohn's disease is expanding as we learn more of the significance of disease distribution and response to treatment...
February 15, 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28209101/role-of-heart-rate-variability-in-predicting-post-endoscopic-retrograde-cholangiopancreatography-pancreatitis
#4
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
#5
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/28203125/migration-of-surgical-clips-into-the-common-bile-duct-after-laparoscopic-cholecystectomy
#6
Krishn Kant Rawal
Laparoscopic cholecystectomy (LC) is currently the treatment of choice for symptomatic gallstones. Associated complications include bile duct injury, retained common bile duct (CBD) stones, and migration of surgical clips. Clip migration into the CBD can present with recurrent cholangitis over a period of time. Retained CBD stones can be another cause of recurrent cholangitis. A case of two surgical clips migrating into the common bile duct with few retained stones following LC is reported here. The patient had repeated episodes of fever, pain at epigastrium, jaundice, and pruritus 3 months after LC...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28196389/conversion-of-external-percutaneous-transhepatic-biliary-drainage-to-endoscopic-ultrasound-guided-hepaticogastrostomy-after-failed-standard-internal-stenting-for-malignant-biliary-obstruction
#7
Woo Hyun Paik, Nah Kyum Lee, Yousuke Nakai, Hiroyuki Isayama, Dongwook Oh, Tae Jun Song, Sang Soo Lee, Dong-Wan Seo, Sung Koo Lee, Myung-Hwan Kim, Do Hyun Park
Background and study aim Percutaneous transhepatic biliary drainage (PTBD) is a rescue procedure after a failed endoscopic retrograde cholangiopancreatography. As PTBD causes patient discomfort, conversion of the PTBD to internal biliary stenting (PTBDS) may be required; however, PTBDS is sometimes difficult because of the tight stricture. We evaluated the efficacy and safety of conversion of external PTBD to endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) after failed PTBDS. Patients and methods A total of 16 patients with malignant distal biliary obstruction who underwent conversion of external PTBD to EUS-HGS after failed PTBDS were enrolled from two institutions in Korea and Japan...
February 14, 2017: Endoscopy
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
#8
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
#9
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/28185764/cholecystectomy-after-gastric-bypass-incidence-and-complications
#10
Viktor Wanjura, Gabriel Sandblom, Johanna Österberg, Lars Enochsson, Johan Ottosson, Eva Szabo
BACKGROUND: Although cholecystectomy incidence is known to be high after Roux-en-Y gastric bypass (RYGB) surgery, the actual increase in incidence is not known. Furthermore, the outcome of cholecystectomy after RYGB is not known. OBJECTIVES: To estimate cholecystectomy incidence before and after RYGB and to compare the outcome of post-RYGB cholecystectomy with the cholecystectomy outcome in the background population. SETTING: Nationwide Swedish multiregister study...
December 12, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28183551/cerebral-air-embolism-after-ercp
#11
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/28181706/efficacy-of-midazolam-versus-propofol-based-sedations-by-non-anesthesiologists-during-therapeutic-endoscopic-retrograde-cholangiopancreatography-in-elderly-patients-over-80-years
#12
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/28178088/aggressive-hydration-with-lactated-ringer-solution-in-prevention-of-postendoscopic-retrograde-cholangiopancreatography-pancreatitis-a-meta-analysis-of-randomized-controlled-trials
#13
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
#14
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
#15
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
#16
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/28162157/-comparison-of-three-surgical-patterns-for-cholecysto-choledocholithiasis
#17
J W Du, J H Jin, W X Hu, Z X Wang, H P Zhao
Objective: To investigate the clinical efficiencies of the three surgical patterns in the treatment of cholecysto-choledocholithiasis (CCL). Methods: A total of 157 patients with CCL, during the period from Janury 2012 to Janury 2016 at the Affiliated Hospital of Inner Mongolia Medical University, were divided into three groups according to surgical patterns: LC-LCBDE Group (laparoscopic cholecystectomy+ laparoscopic common bile duct exploration, n=49), ERCP-LC Group (endoscopic retrograde cholangiopancreatography+ laparoscopic cholecystectomy, n=51) and OC-OCBDE Group (open cholecystectomy+ open common bile duct exploration, n=57)...
January 24, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28160947/the-scope-of-post-ercp-pancreatitis
#18
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/28154911/comparative-performance-of-non-contrast-mri-with-haste-vs-contrast-enhanced-mri-3d-mrcp-for-possible-choledocholithiasis-in-hospitalized-patients
#19
Stella K Kang, Laura Heacock, Ankur M Doshi, Justin R Ream, Jeffrey Sun, James S Babb
PURPOSE: To compare the performance of non-contrast MRI with half-Fourier acquisition single-shot turbo spin echo (HASTE) vs. contrast-enhanced MRI/3D-MRCP for assessment of suspected choledocholithiasis in hospitalized patients. METHODS AND MATERIALS: 123 contrast-enhanced abdominal MRI/MRCP scans in the hospital setting for possible choledocholithiasis were retrospectively evaluated. Endoscopic retrograde cholangiopancreatography, intraoperative cholangiogram or documented clinical resolution served as the reference standard...
February 2, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28154379/editorial-endoscopic-sedation-who-which-when
#20
John M Inadomi
The costs of medical care are rising and media has focused attention on the costs of colonoscopy as a potential cause. A major component of procedural costs is the sedation, which is a combination of the drugs used and who administers them. An analysis of advanced endoscopic procedures revealed that the rate of sedation failure was significantly lower among patients administered sedation by anesthesia compared with patients who received moderate sedation administered by endoscopy staff. The authors argue that all endoscopic retrograde cholangiopancreatography (ERCP) should be performed with anesthesia-administered sedation...
February 2017: American Journal of Gastroenterology
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