Rectal indomethacin does not prevent pancreatitis post ERCP
Patients who receive rectal indomethacin after undergoing endoscopic retrograde cholangiopancreatography (ERCP) are not any less likely to develop pancreatitis than individuals who don’t, according...
We present the case of a 43-year-old female diagnosed with a pancreatobiliary maljunction and an associated stenosis of the bile duct, secondary to an episode of acute pancreatitis. She underwent several endoscopic retrograde cholangiopancreatography procedures over the course of three years, without improvement of the stenosis, and therefore a surgical approach was taken. Prior to the surgical intervention, magnetic resonance imaging showed the presence of an 11-mm polyp in the gallbladder. A histological study of the surgical sample identified intramucosal adenocarcinoma over a tubular adenoma of the gallbladder. Pancrea...
Conclusions Low serum trypsin levels independently predict DPC failure during ERCP in patients with symptomatic obstructive CP.
Indomethacin down-regulating HMGB1 and TNF-α to prevent pancreatitis after endoscopic retrograde cholangiopancreatography. Scand J Gastroenterol. 2019 Jun 08;:1-7 Authors: Li L, Liu M, Zhang T, Jia Y, Zhang Y, Yuan H, Zhang G, He C Abstract Background and aims: Several articles demonstrated that non-steroidal anti-inflammation drugs (NSAIDs) were effective in reducing the incidence of pancreatitis after endoscopic retrograde cholangiopancreatography (PEP). However, studies revealed inconsistent results. The mechanism of NSAIDs in preventing PEP is still little known. Therefore, the aim of our stu...
This report emphasizes the significance of pathological confirmation before starting treatment, even in cases with diffuse pancreatic enlargement. PMID: 31178502 [PubMed - as supplied by publisher]
No abstract available
CONCLUSIONS: In patients diagnosed with acute gallstone pancreatitis, it is reasonable to proceed directly to surgery using intraoperative cholangiography on the same admission as the definitive assessment of the common bile duct. This negates the need for magnetic resonance cholangiopancreatography and can translate into cost savings and reduced length of stay. PMID: 31155897 [PubMed - as supplied by publisher]
Conclusions: Forward-viewing endoscopes can be effectively used in patients with altered GI anatomy by facilitating the access to the papilla and bile duct cannulation without increasing the incidence of complications.
The post Endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis is a critical and not-controlled complication of ERCP. Many articles have been published to identify risk factors for post ERCP pancreatitis (PEP). However, there was few data on the risk factors limiting only beginners. We aims revealed the risk factors in PEP at beginners.
Endoscopic sphincterotomy (ES) is routinely performed before placement of biliary self-expandable metallic stents (SEMS). However, there is still controversy regarding the benefit of ES before the placement of biliary stents. ES may facilitate insertion of SEMS, but is independently associated with post-ERCP pancreatitis (PEP), bleeding, and perforation. The aim of the study was to investigate the outcome of patients with malignant biliary obstruction undergoing SEMS placement with and without ES.
Gallstone disease is a common clinical problem that leads to pancreatitis and cholangitis if left undiagnosed. Guidelines from the American Society for Gastrointestinal Endoscopy (ASGE) categorize patients with suspected choledocholithiasis (CDL) into 3 risk categories (low, intermediate, high) based on prognostic indicators. When compared to endoscopic ultrasound (EUS), these guidelines may result in unnecessary endoscopic retrograde cholangiopancreatographies (ERCPs) and associated complications.