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Acute biliary pancreatitis

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
Ali Majdoub, Mabrouk Bahloul, Mounaa Ouaz, Kamilia Chtara, Yassine Msakni, Kais Regaieg, Mounir Bouaziz, Bechir Haddad
No abstract text is available yet for this article.
July 2016: International Journal of Critical Illness and Injury Science
Shinjiro Kobayashi, Horoyuki Hoshino, Kouhei Segami, Satoshi Koizumi, Nobuyuki Ooike, Takehito Otsubo
The patient was a 56-year-old woman who had experienced epigastralgia and dorsal pain several times over the last 20 years. She was admitted for a diagnosis of acute cholecystitis, and severe intra- and extrahepatic bile duct dilatation with inner air density was noted. No papilla of Vater was present in the descending duodenum, and 2 small holes were present in the pyloric ring. Bile excretion from one of the small holes was observed under forward-viewing endoscope. It was considered that the pancreatic and bile ducts separately opened into the pyloric ring...
May 2016: Case Reports in Gastroenterology
Tim Ragnarsson, Roland Andersson, Daniel Ansari, Ulf Persson, Bodil Andersson
BACKGROUND: International guidelines recommend cholecystectomy within 2-4 weeks after mild-moderate acute biliary pancreatitis (ABP) to prevent recurrence. We aimed to investigate the compliance to guidelines concerning early cholecystectomy and the associated costs. METHODS: Admissions for ABP 2011-2013 were retrospectively reviewed. Classification was made according to the revised Atlanta classification. Treatment, time to surgery and recurrence, as well as cost analysis for both in-hospital costs and loss of production was performed...
October 4, 2016: Scandinavian Journal of Gastroenterology
Sezgin Zeren, Zulfu Bayhan, Cengiz Koçak, Fatma Emel Koçak, Mehmet Huseyin Metineren, Bircan Savran, Havva Kocak, Mustafa Cem Algin, Cuneyt Kahraman, Ahmet Kocak, Suleyman Cosgun
: Purpose/Aim: Oxidative stress plays an important role in the pathogenesis of acute pancreatitis (AP). We compared the therapeutic effects of Ukrain (NSC 631570) and N-acetylcysteine (NAC) in rats with AP. MATERIALS AND METHODS: Forty male Sprague Dawley rats were divided into four groups: controls; AP; AP with NAC; and AP with Ukrain. AP was induced via the ligation of the bile-pancreatic duct; drugs were administered intraperitoneally (i.p.) 30 min and 12 h after AP induction...
October 3, 2016: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
Georgia Dedemadi, Manolis Nikolopoulos, Ioannis Kalaitzopoulos, George Sgourakis
Cholelithiasis is the most common cause of acute pancreatitis, accounting 35%-60% of cases. Around 15%-20% of patients suffer a severe attack with high morbidity and mortality rates. As far as treatment is concerned, the optimum method of late management of patients with severe acute biliary pancreatitis is still contentious and the main question is over the correct timing of every intervention. Patients after recovering from an acute episode of severe biliary pancreatitis can be offered alternative options in their management, including cholecystectomy, endoscopic retrograde cholangiopancreatography (ERCP) and sphincterotomy, or no definitive treatment...
September 14, 2016: World Journal of Gastroenterology: WJG
Dr Mélanie Fromentin, Remy Gauzit, Benoit Gille, Charles Marc Samama
Genital herpes is increasingly caused by herpes simplex virus type 1 (HSV-1), but recurrences are less frequent than with HSV-2. Distinguishing between primary genital infection and reactivation can be difficult, but HSV-1 more often causes severe primary infections and fewer recurrences. However, as virus reactivation is common during septic shock, a severe form of HSV-1 reactivation can occur in locations other than the lungs, which remain the most common site. The case of a 79-year-old Caucasian man who presented with HSV-1 epididymo-orchitis after three episodes of severe sepsis or septic shock in the context of acute biliary necrotizing pancreatitis is described...
2016: IDCases
Mohammad S Khuroo, Ajaz A Rather, Naira S Khuroo, Mehnaaz S Khuroo
Hepatobiliary and pancreatic ascariasis (HPA) was described as a clinical entity from Kashmir, India in 1985. HPA is caused by invasion and migration of nematode, Ascaris lumbricoides, in to the biliary tract and pancreatic duct. Patients present with biliary colic, cholangitis, cholecystitis, hepatic abscesses and acute pancreatitis. Ascarides traverse the ducts repeatedly, get trapped and die, leading to formation of hepatolithiasis. HPA is ubiquitous in endemic regions and in Kashmir, one such region, HPA is the etiological factor for 36...
September 7, 2016: World Journal of Gastroenterology: WJG
T Flaig, A Douros, E Bronder, A Klimpel, R Kreutz, E Garbe
WHAT IS KNOWN AND OBJECTIVE: Tocilizumab (TCZ) is a humanized monoclonal antibody acting against the IL-6 receptor. It is a drug used in the treatment of rheumatoid arthritis and can be either given intravenously every 4 weeks or subcutaneously once a week. Known adverse events (AE) associated with TCZ include: infections of the upper respiratory tract, arterial hypertension, hypercholesterolaemia and hypertriglyceridaemia. Here, we present the first well-documented case of TCZ-induced acute pancreatitis (AP) and a systematic review of the literature including data from the Food and Drug Administration Adverse Event Reporting System (FAERS) database...
September 27, 2016: Journal of Clinical Pharmacy and Therapeutics
Sebastian Rasch, Veit Phillip, Stephanie Reichel, Bettina Rau, Christian Zapf, Jonas Rosendahl, Ulrich Halm, Markus Zachäus, Martin Müller, Alexander Kleger, Albrecht Neesse, Jochen Hampe, Mark Ellrichmann, Felix Rückert, Peter Strauß, Alexander Arlt, Volker Ellenrieder, Thomas M Gress, Werner Hartwig, Ernst Klar, Joachim Mössner, Stefan Post, Roland M Schmid, Thomas Seufferlein, Marco Siech, Jens Werner, Uwe Will, Hana Algül
BACKGROUND: Necrotising pancreatitis, and particularly infected necrosis, are still associated with high morbidity and mortality. Since 2011, a step-up approach with lower morbidity rates compared to initial open necrosectomy has been established. However, mortality and complication rates of this complex treatment are hardly studied thereafter. METHODS: The German Pancreatitis Study Group performed a multicenter, retrospective study including 220 patients with necrotising pancreatitis requiring intervention, treated at 10 hospitals in Germany between January 2008 and June 2014...
2016: PloS One
Ankur Gupta, Praveer Rai, Vivek Singh, Rakesh Kumar Gupta, Vivek Anand Saraswat
BACKGROUND: Knowledge about anatomic variations in intrahepatic biliary ducts (IHBD) is relevant for performing biliary drainage and for avoiding bile duct injury during cholecystectomy and liver resections. Low insertion of cystic duct (LICD) is a common anatomic variant. Pancreas divisum is the commonest congenital anomaly of pancreas; it has been causally linked with recurrent acute pancreatitis (RAP). METHODS: Magnetic resonance cholangiopancreaticography (MRCP) images of 500 consecutive patients were reviewed for anatomic variants of IHBD, cystic duct, and pancreatic duct...
September 2016: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
Rabindra R Watson, Jason Klapman, Srinadh Komanduri, Janak N Shah, Sachin Wani, Raman Muthusamy
BACKGROUND: Sphincter of Oddi manometry (SOM) is recommended in the evaluation of suspected Type II sphincter of Oddi dysfunction (SOD2), though its utility is uncertain. Little is known about the practice of expert endoscopists in the United States regarding SOD2. METHODS: An anonymous electronic survey was distributed to 128 expert biliary endoscopists identified from U.S. advanced endoscopy training programs. RESULTS: The response rate was 46...
September 2016: Endoscopy International Open
Jay Song, Sung Bum Kim, Kook Hyun Kim, Tae Nyeun Kim, Kyung Hee Lee
BACKGROUND: Gallbladder toxicity was reported in most motesanib studies with varying frequency and at variable times after initiation of treatment. METHOD AND RESULTS: A 44-year-old man was admitted due to severe epigastric pain. The patient was diagnosed with non-small cell lung cancer 9 months ago and received 6 cycles of chemotherapy with motesanib, paclitaxel, and carboplatin. Ultrasonography showed a large amount of sludge within gallbladder. Computed tomography scan demonstrated diffuse dilatation of biliary tree with distended gallbladder without evidence of stone and mild pancreatic swelling...
September 2016: Medicine (Baltimore)
Radan Keil
UNLABELLED: Pancreatitis of biliary etiology accounts for 30-60 % of all cases of acute pancreatitis. A number of randomized studies have been completed to assess the role of acute endoscopic retrograde cholangiopancreatography (ERCP) and papilosphincterotomy in the therapy of biliary pancreatitis. Analysis of the respective studies has shown that urgent endoscopy is clearly indicated for the patients with a severe form of acute biliary pancreatitis as well as for those with an ongoing acute cholangitis or obstructive icterus...
2016: Vnitr̆ní Lékar̆ství
Chandraprakash Umapathy, Amit Raina, Shreyas Saligram, Gong Tang, Georgios I Papachristou, Mordechai Rabinovitz, Jennifer Chennat, Herbert Zeh, Amer H Zureikat, Melissa E Hogg, Kenneth K Lee, Melissa I Saul, David C Whitcomb, Adam Slivka, Dhiraj Yadav
BACKGROUND: Most studies of acute necrotizing pancreatitis (ANP) focus on short-term outcomes. We evaluated long-term survival and outcomes following ANP. METHODS: Patients treated for ANP at the University of Pittsburgh Medical Center from 2001 to 2008 were studied. Data on presentation and course during initial hospitalization and follow-up (median 34 months) was extracted. RESULTS: Mean age of patients (n = 167) was 53 ± 16 years; 70 % were male, 94 % white, 71 % transfers, 52 % biliary etiology, and 78 % had first-attack of acute pancreatitis...
September 12, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Mirella Fraquelli, Giovanni Casazza, Dario Conte, Agostino Colli
BACKGROUND: Cholelithiasis refers to the presence of gallstones, which are concretions that form in the biliary tract, usually in the gallbladder. Cholelithiasis is one of the most common surgical problems worldwide and is particularly prevalent in most Western countries.Biliary colic is the term used for gallbladder pain experienced by a person with gallstones and without overt infection around the gallbladder. It is the most common manifestation of cholelithiasis, observed in over one-third of people with gallstones over the course of 10 or more years...
September 9, 2016: Cochrane Database of Systematic Reviews
Filippo Antonini, Raffaele Pezzilli, Lucia Angelelli, Giampiero Macarri
An increased incidence of pancreatic disorders either acute pancreatitis or chronic pancreatitis has been recorded in patients with inflammatory bowel disease (IBD) compared to the general population. Although most of the pancreatitis in patients with IBD seem to be related to biliary lithiasis or drug induced, in some cases pancreatitis were defined as idiopathic, suggesting a direct pancreatic damage in IBD. Pancreatitis and IBD may have similar presentation therefore a pancreatic disease could not be recognized in patients with Crohn's disease and ulcerative colitis...
August 15, 2016: World Journal of Gastrointestinal Pathophysiology
Mika Ukkonen, Antti Siiki, Anne Antila, Tuula Tyrväinen, Juhani Sand, Johanna Laukkarinen
BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) is a frequent procedure in elderly patients. AIMS: We aimed to determine the safety and efficacy of acute ERCP in older patients. METHODS: A prospectively managed, hospital-based registry containing all ERCP procedures and complications at a tertiary referral center was used to form the study population, which consisted of consecutive elderly (≥65 years) patients undergoing acute ERCP during the 5-year study period...
November 2016: Digestive Diseases and Sciences
Yuichi Takano, Masatsugu Nagahama, Naotaka Maruoka, Eiichi Yamamura, Nobuyuki Ohike, Tomoko Norose, Hiroshi Takahashi
BACKGROUND AND STUDY AIMS: Gallstone impaction at the ampulla of Vater is a critical condition, and the standard treatment is endoscopic papillotomy. However, the clinical features remain largely unclear, and some patients are reluctant to undergo papillotomy because of a bleeding tendency. The aim of this study was to clarify the clinical features of gallstone impaction at the ampulla of Vater and to examine the effectiveness of endoscopic biliary drainage without papillotomy. PATIENTS AND METHODS: We retrospectively examined 30 patients who had undergone endoscopic treatment for gallstone impaction at the ampulla of Vater between 2010 and 2015...
July 2016: Endoscopy International Open
Shir Li Jee, Razman Jarmin, Kin Foong Lim, Krishnan Raman
BACKGROUND: In patients with acute biliary pancreatitis (ABP), cholecystectomy is mandatory to prevent further biliary events, but the precise timing of cholecystectomy for mild to moderate disease remain a subject of ongoing debate. The aim of this study is to assess the outcomes of early versus delayed cholecystectomy. We hypothesize that early cholecystectomy as compared to delayed cholecystectomy reduces recurrent biliary events without a higher peri-operative complication rate. METHODS: Patients with mild to moderate ABP were prospectively randomized to either an early cholecystectomy versus a delayed cholecystectomy group...
August 13, 2016: Asian Journal of Surgery
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