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Post-endoscopic Retrograde Cholangiopancreatography Pancreatitis (post-endoscopic + retrograde_cholangiopancreatography_pancreatitis)
Selected AbstractsGuidewire cannulation increases the success rate of needle-knife fistulotomy for difficult bile duct accessJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 1 2010Kyoung W Yoon Abstract Background and Aim:, Selective bile duct cannulation is a prerequisite for performing therapeutic endoscopic biliary intervention. This study aimed to evaluate if using a soft-tipped guidewire to cannulate the bile duct would increase the success rate of needle-knife fistulotomy for difficult bile duct access. Methods:, We reviewed sixty 60 patients with difficult bile duct access who underwent conventional cannulation with radiocontrast dye (29) or guidewire cannulation (31) after needle-knife fistulotomy. Results:, There were no significant differences in the demographic data between the two groups. The initial success rate of selective bile duct cannulation was significantly higher in the guidewire cannulation group compared with the conventional cannulation group: 100% versus 79.3%, P = 0.009. The success rate of selective biliary cannulation in the patients with non-dilated common bile duct (< 8 mm) was significantly higher in the guidewire cannulation group compared with the conventional cannulation group: 100% versus 68.4%, P = 0.003. The incidence of post-endoscopic retrograde cholangiopancreatography pancreatitis was not significantly different between the two groups. No serious complications occurred in either group. Conclusions:, In this retrospective and small case series, guidewire cannulation after needle-knife fistulotomy increased the success rate of selective bile duct cannulation in patients with difficult bile duct access. [source] Role of diclofenac in reducing post-endoscopic retrograde cholangiopancreatography pancreatitisJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 7pt2 2008Manouchehr Khoshbaten Abstract Background and Aims:, Acute pancreatitis following endoscopic retrograde cholangiography presents a unique opportunity for prophylaxis and early modification of the disease process because the initial triggering event is temporally well defined and takes place in the hospital. We report a prospective, single-center, randomized, double-blind controlled trial to determine if rectal diclofenac reduces the incidence of pancreatitis following cholangiopancreatography. Methods:, Entry to the trial was restricted to patients who underwent endoscopic retrograde pancreatography. Immediately after endoscopy, patients were given a suppository containing either 100 mg diclofenac or placebo. Estimation of serum amylase level and clinical evaluation were performed in all patients. Results:, One hundred patients entered the trial, and 50 received rectal diclofenac. Fifteen patients developed pancreatitis (15%), of whom two received rectal diclofenac and 13 received placebo (P < 0.01). Conclusions:, This trial shows that rectal diclofenac given immediately after endoscopic retrograde cholangiopancreatography can reduce the incidence of acute pancreatitis. [source] Protocol-based management strategy for post-endoscopic retrograde cholangiopancreatography pancreatitis: Can it make a difference?JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 3 2008Deepak K Bhasin [source] Meta-analysis: octreotide prevents post-ERCP pancreatitis, but only at sufficient dosesALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 11 2009Y. ZHANG Summary Background, Effects of octreotide on post-endoscopic retrograde cholangiopancreatography pancreatitis have been studied in many clinical trials. These trials have yielded inconclusive results. Results of more recent studies using larger doses, however, seem to be more optimistic. Aim, To examine effects of octreotide at different doses on PEP. Methods, A comprehensive search of relevant databases, including Medline, Embase, the Cochrane Controlled Trials Register, the Cochrane Library and Science Citation Index yielded 18 randomized controlled trials (RCTs). Trials were divided into two groups according to the total dosage of octreotide: <0.5 mg (OCT1), ,0.5 mg (OCT2). The rate of PEP was analysed using a fixed effect model. Results, At doses of ,0.5 mg, octreotide reduced the rate of PEP. In the OCT2 group, analysis revealed a statistically significant difference on PEP between the octreotide group and the controls (3.4% vs. 7.5%, pooled OR = 0.45; 95% CI: 0.28,0.73; P = 0.001, NNT = 25). In the OCT1 group, the rate of PEP was similar between patients receiving octreotide and the controls (7.2% vs. 6.0%, pooled OR = 1.23; 95% CI: 0.80,1.91; P = 0.35). Conclusion, Octreotide is effective in preventing PEP, but only at sufficient doses (,0.5 mg). [source] | ||||||||||