Accepted Article. If you suffer from type-2 diabetes mellitus, your ERCP is likely to have a better outcome. Jesús García-Cano
|
|
- Colin Tyler
- 5 years ago
- Views:
Transcription
1 Accepted Article If you suffer from type-2 diabetes mellitus, your ERCP is likely to have a better outcome Jesús García-Cano DOI: /reed /2016 Link: PDF Please cite this article as: García-Cano Jesús. If you suffer from type-2 diabetes mellitus, your ERCP is likely to have a better outcome. Rev Esp Enferm Dig doi: /reed /2016. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
2 If you suffer from type-2 diabetes mellitus, your ERCP is likely to have a better outcome Jesús García-Cano Department of Digestive Diseases. Virgen de la Luz Hospital. Cuenca, Spain Biliary endoscopic sphincterotomy (BES) was first performed in 1973, almost at the same time, in Germany and Japan (1,2). It was initially intended to remove common bile duct stones (CBDS) or choledocholithiasis in patients who had previously undergone cholecystectomy. In this way, a new surgery was no longer needed in a majority of such patients. Since 1973 the procedure has expanded over the years and is now a widespread tehcnique in biliary endoscopy. A PubMed search in July 2016 of the MeSH (Medical Subject Heading) term "Sphincterotomy, Endoscopic" yealded 2,929 articles. BES is defined as an incision of Oddi's sphincter or Vater's ampulla performed by inserting a sphincterotome through an endoscope (duodenoscope) often following retrograde cholangiography. Endoscopic treatment by sphincterotomy is the preferred method of treatment for patients with retained or recurrent bile duct stones postcholecystectomy, and for poor-surgical-risk patients who have the gallbladder still present. Furthermore, BES is commonly performed prior to stent insertion (plastic or metal). BES is a part of the procedure called endoscopic retrograde cholangiopancreatography (ERCP), which has, in turn, 14,025 articles in PubMed. The technique for Oddi s sphincter incision has not basically changed since It is performed with pull-type or Erlangen-type sphincterotomes. The latter denomination refers to the first German city where the procedure was first used. Tension is given to the device wire, electric current is applied (nowadays a blended current consisting of cut and coagulation) and the papilla of Vater is opened in a stepwise manner (Fig. 1). The terms papillotomy (from Vater s papilla) and sphincterotomy (from Oddi s sphincter within the Vater s papilla) are synonimous.
3 Pancreatic endoscopic sphincterotomy (PES) can be also performed cutting Oddi s sphincter from the pancreatic side. It is done to treat main pancreatic duct conditions or, more commonly in recent times, to reach the CBD in the so-called pancreatic techniques for CBD cannulation (3). After 43 years of BES use worldwide, the four most frequently found complications include post-ercp acute pancreatitis, bleeding, perforation, and cholangitis. Nevertheless, infection is not directly related to BES, but to failed biliary drainage after contrast injection during ERCP. In the same way, post-ercp acute pancreatitis is not only related to potential thermal injury because of the electrical current applied during BES, but also to previous cannulation attempts. The crucial point during ERCP procedures is the deep cannulation of either the CBD or pancreatic duct, or both. The vast majority of ERCPs aim at CBD drainage. Cannulation skills are so important that they constitute a surrogate for total ERCP competency performance (4). In fact, once deep CBD cannulation has been achived, other techniques such as BES or stent insertion are straigthforward. Cannulation technique is believed to be a pivotal factor in the genesis of post-ercp pancreatitis, and is obviously important for successful cannulation. The two major persistent problems of ERCP over time are failure of successful biliary cannulation and post-ercp pancreatitis (5). After 43 years of BES life span, we may be led to think all has been said about BES outocomes, risks, and complication prevention. For instance, we learned that ERCP is more dangerous in people who do not need it (6), that fewer doctors should perform more ERCPs in order to mantain skills (7), that aged people can be safely treated by ERCP (8), that the whole team of physicians, nurses and other assitants must have good training since a weak link can determine a bad outcome (9). And in summary, non dilated ducts, absence of obstructive jaundice, women under 60 years of age, and treating sphincter of Oddi dysfunction lead to frequent and sometimes severe complications (10). But very litle was known about the better outcomes of ERCP in patients suffering from type-2 diabetes mellitus (T2DM), as de Miguel-Yanes et al. point out in this month's issue of Revista Española de Enfermedades Digestivas (Spanish Journal of
4 Gastroenterology) (11). Scarce references may be found that show links between ERCP and diabetes. In the last few years Uchino et al. (12) reported that patients with diabetes had more frequently painless post-ercp acute pancreatitis, and Hu et al. (13) found similar complication rates after ERCP regardless of diabetes status. De Miguel-Yanes et al. (11) used disease- and procedure-related criteria according to the International Classification Diseases-Ninth Revision, Clinical Modification (ICD-9- CM codes), which is used in the Spanish Minimum Basic Data Set managed by the Ministry of Health. The authors compared 23,002 BES procedures in patients with T2DM against 103,883 procedures in patients without T2DM. In this huge database they searched for code endoscopic sphincterotomy and papillotomy, code endoscopic dilation of ampulla and biliary tract, and code endoscopic insertion of stent (tube) into bile duct. They did not look for ERCP (code 51.10, and 52.13) to discard non-therapeutic ERCP. With appropriate ICD9-CM codes they excluded type-1 diabetes mellitus, gallbladder o pancreatic cancer, and people younger than 18 years old. Obese people was also identified. They looked also for codes related to BES complications such as cholangitis, acute pancreatitis, peforation, and bleeding. T2DM was found to be associated with lower in-hospital mortality after BES. Time trend multivariate analyses during years 2003 to 2013 showed a significant reduction for in-hospital mortality after BES only in patients who had T2DM. Obesity was more frequently coded in the T2DM population. The better outcomes associated with obesity have been described in the so-called obesity paradox in patients undergoing percutaneous coronary intervention (14). Earlier I tried to show that ERCP success depends mainly on single-operator volume of procedures and skills, rather than total number of ERCPs performed in a hospital (15). Similar results were found by other colleagues (16). Something similar to ERCP had been reported for cardiovascular procedures. What matters most is how many procedures are performed by each doctor (17). Again, cardiological and endoscopic procedures have in common the fact that moderate obesity is perhaps related to better outcomes.
5 De Miguel-Yanes et al s. work (11) is based on the ICD-9-CM codes asigned to each certificate of discharge. In Spain, codes asignement is usually done by trained staff rather than gastroenterologists, so they ignore some aspects and techniques related to ERCP. Therefore, perhaps many procedures were coded exclusively as ERCP without any reference to therapeutic details, like BES. Spanish endoscopists are not as familiar with coding procedures as they should be. Thus, complexity and case mix can be properly displayed. Adequate ICD-9-CM coding for ERCP may include other tecniques such as cannulation of the pancreatic duct, contrast pancreatogram, or pancreatic sphincterotomy. There are some issues in the paper by de Miguel-Yanes et al. (11) that need explanation. In-hospital mortality was found to be lower for T2DM patients, with further reductions reported over time, whereas, for instance, post-ercp acute pancreatitis rate is higher in this subset than for patients without T2DM. It is not surprising that older age, comorbidity, and BES performed in an emergency setting had the highest in-hospital mortality rate. A more in-depth analisys could have been done to show how T2DM patients falling in these three risk categories (older, comorbidity, urgent ERCP) were protected by their diabetes. It remains open the question of which mechanisms in type-2 diabetes mellitus serve as protective agents. In addition, as the authors stated, more studies are needed to confirm that these results are present in real clinical scenarios and not as merely statistics. Despite some criticisms, the work by de Miguel-Yanes et al. (11) is of great scientific value. It is, to my knowledge, the largest Spanish ERCP series, comprising 126,885 BES from 2003 to It emphasizes the fact that large-scale nation-wide studies can be done. This article shows that the data collected by the Spanish National Hospital Database (MBDS, Minimum Basic Data Set) managed by the Spanish Ministry of Health, Social Policy and Equality, compiling data from all public and private hospitals, covering the vast majority of hospital discharges, is a valuable tool for high-quality scientific studies.
6 REFERENCES 1. Classen M, Demling L. Endoscopic sphincterotomy of the papilla of vater and extraction of stones from the choledochal duct. Dtsch Med Wochenschr 1974;99: Kawai K, Akasaka Y, Murakami K, et al. Endoscopic sphincterotomy of the ampulla of Vater. Gastrointest Endosc 1974;20: García-Cano J, Taberna-Arana L. A prospective assessment of pancreatic techniques used to achieve common bile duct cannulation in ERCP. Digestive Disease Week. San Diego (California) may Gastrointest Endosc 2012;75:(4S) AB389 [abstract]. 4. García-Cano J. 200 supervised procedures: the minimum threshold number for competency in performing endoscopic retrograde cholangiopancreatography. Surg Endosc 2007;21: Bourke MJ, Costamagna G, Freeman ML. Biliary cannulation during endoscopic retrograde cholangiopancreatography: core technique and recent innovations. Endoscopy 2009;41: Cotton PB. ERCP is most dangerous for people who need it least. Gastrointest Endosc 2001;54: Huibregtese K. Complications of endoscopic sphincterotomy and their prevention (editorial). N Engl J Med 1996;335: García-Cano J. Endoscopic retrograde cholangiopancreatography in patients 90 years of age and older: increasing experience on its effectiveness and safety. J Clin Gastroenterol 2003;37: García-Cano J. ERCP outcomes in medium-volume centers. Gastrointest Endosc 2007;65: Freeman ML, Disario JA, Nelson DB, et al. Risk factors for post ERCP pancreatitis: a prospective, multicenter study. Gastrointest Endosc 2001;54: de Miguel-Yanes J, Méndez-Bailón M, Jiménez-García R, et al. Tendencies and outcomes in endoscopic biliary sphincterotomies among people with or without type 2 diabetes mellitus in Spain, Rev Esp Enferm Dig 2016;xx:xx-xx.
7 12. Uchino R, Sasahira N, Isayama H, et al. Detection of painless pancreatitis by computed tomography in patients with post-endoscopic retrograde cholangiopancreatography hyperamylasemia. Pancreatology 2014;14: Hu KC, Chang WH, Chu CH, et al. Findings and risk factors of early mortality of endoscopic retrograde cholangiopancreatography in different cohorts of elderly patients. J Am Geriatr Soc 2009;57: Gruberg L, Weissman NJ, Waksman RF, et al. The impact of obesity on the shortterm and long-term outcomes after percutaneous coronary intervention: The obesity paradox? J Am Coll Cardiol 2002;39: Garcia-Cano J, González Martín JA, Morillas Ariño J, et al. Complications of endoscopic retrograde cholangiopancreatography. A study in a small ERCP unit. Rev Esp Enferm Dig 2004;96: Riesco-López JM, Vázquez-Romero M, Rizo-Pascual JM, et al. Efficacy and safety of ERCP in a low-volume hospital. Rev Esp Enferm Dig 2013;105: Birkmeyer JD, Stukel TA, Siewers AE, et al. Surgeon volume and operative mortality in the United States. N Engl J Med 2003;349: Cotton PB. How many times have you done this procedure, doctor? Am J Gastroenterol 2002;97:522-3.
8 Fig. 1. Endoscopic biliary sphincterotomy.
Title: Pursuing excellence in ERCP. Authors: Jesús García-Cano, Francisco Domper. DOI: /reed /2017 Link: PubMed (Epub ahead of print)
Title: Pursuing excellence in ERCP Authors: Jesús García-Cano, Francisco Domper DOI: 10.17235/reed.2018.5373/2017 Link: PubMed (Epub ahead of print) Please cite this article as: García-Cano Jesús, Domper
More informationTitle: The best approach to treat concomitant gallstones and. Authors: Jesús García-Cano, Francisco Domper
Title: The best approach to treat concomitant gallstones and common bile duct stones. Is ERCP still needed? Authors: Jesús García-Cano, Francisco Domper DOI: 10.17235/reed.2019.6226/2019 Link: PubMed (Epub
More informationBiliary sphincterotomy dilation for the extraction of difficult common bile duct stones
1130-0108/2009/101/8/541-545 REVISTA ESPAÑOLA DE ENFERMEDADES DIGESTIVAS Copyright 2009 ARÁN EDICIONES, S. L. REV ESP ENFERM DIG (Madrid) Vol. 101. N. 8, pp. 541-545, 2009 Biliary sphincterotomy dilation
More informationTitle: The endoscopic ultrasound-assisted Rendez-Vous technique for treatment of recurrent pancreatitis due to pancreas divisum and ansa pancreatica
Title: The endoscopic ultrasound-assisted Rendez-Vous technique for treatment of recurrent pancreatitis due to pancreas divisum and ansa pancreatica Authors: Sergio López-Durán, Celia Zaera, Juan Ángel
More informationTitle: Painless jaundice as an initial presentation of lung adenocarcinoma
Title: Painless jaundice as an initial presentation of lung adenocarcinoma Authors: Irene Andaluz García, Irene González Partida, Javier Lucas Ramos, Jorge Yebra Carmona DOI: 10.17235/reed.2018.5587/2018
More informationTitle: Pancreatic stents in ERCP. Where are we? Authors: Francisco Pérez Roldán, Pedro González Carro
Title: Pancreatic stents in ERCP. Where are we? Authors: Francisco Pérez Roldán, Pedro González Carro DOI: 10.17235/reed.2018.5670/2018 Link: PubMed (Epub ahead of print) Please cite this article as: Pérez
More informationTitle: Insertion of fully covered self-expanding. metal stents in benign biliary diseases. Rev
Title: Insertion of fully covered self-expanding metal stents in benign biliary diseases Authors: Mariana Omodeo, Ignacio Malaga, Dante Manazzoni, Cecilia Curvale, Julio de Maria, Martín Alejandro Guidi,
More informationTitle: Fasciola hepatica in the common bile duct: spyglass visualization and endoscopic extraction
Title: Fasciola hepatica in the common bile duct: spyglass visualization and endoscopic extraction Authors: Edson Guzmán Calderón, Augusto Vera Calderón, Ramiro Díaz Ríos, Ronald Arcana López, Edgar Alva
More informationEndoscopic Papillary Balloon Dilation with Large Balloon after Limited Sphincterotomy for Retrieval of Choledocholithiasis
Yonsei Medical Journal Vol. 47, No. 6, pp. 805-810, 2006 Endoscopic Papillary Balloon Dilation with Large Balloon after Limited Sphincterotomy for Retrieval of Choledocholithiasis Seungmin Bang, Myoung
More informationORIGINAL PAPERS. R. Insertion of fully covered self-expanding metal stents in benign biliary diseases. ABSTRACT MATERIALS AND METHODS INTRODUCTION
ORIGINAL PAPERS Insertion of fully covered self-expanding metal stents in benign biliary diseases Mariana Omodeo, Ignacio Málaga, Dante Manazzoni, Cecilia Curvale, Julio de María, Martín Guidi and Raúl
More informationFully covered self-expanding metal stents in the management of difficult common bile duct stones
1130-0108/2013/105/1/7-12 REVISTA ESPAÑOLA DE ENFERMEDADES DIGESTIVAS Copyright 2013 ARÁN EDICIONES, S. L. REV ESP ENFERM DIG (Madrid) Vol. 105. N. 1, pp. 7-12, 2013 ORIGINAL PAPERS Fully covered self-expanding
More informationEndoscopic Retrograde Cholangiopancreatography (ERCP)
Endoscopic Retrograde Cholangiopancreatography (ERCP) Medical Imaging and Treatment of the Bile and Pancreatic Ducts CIE-02718 Understanding ERCP Brochure Update_F.indd 1 7/11/18 9:51 A Minimally Invasive
More informationPrinciples of ERCP: papilla cannulation, indications/contraindications and risks. Dr. med. Henrik Csaba Horváth PhD
Principles of ERCP: papilla cannulation, indications/contraindications and risks Dr. med. Henrik Csaba Horváth PhD Evolution of ERCP 1968. 1970s ECPG Endoscopic CholangioPancreatoGraphy Japan 1974 Biliary
More informationSafety of endoscopic retrograde cholangiopancreatography in patients 80 years of age and older
Original paper Safety of endoscopic retrograde cholangiopancreatography in patients 80 years of age and older Baydar Behlül 1, Serin Ayfer 2, Vatansever Sezgin 3, Kandemir Altay 3, Çelik Mustafa 3, Çekiç
More informationObstructive jaundice due to a blood clot after ERCP: a case report and review of the literature
Zhu et al. BMC Gastroenterology (2018) 18:163 https://doi.org/10.1186/s12876-018-0898-4 CASE REPORT Open Access Obstructive jaundice due to a blood clot after ERCP: a case report and review of the literature
More informationRecurrent common bile duct stones as a late complication of endoscopic sphincterotomy
Nzenza et al. BMC Gastroenterology (2018) 18:39 https://doi.org/10.1186/s12876-018-0765-3 RESEARCH ARTICLE Open Access Recurrent common bile duct stones as a late complication of endoscopic sphincterotomy
More informationTitle: An intrahepatic cavoportal collateral pathway due to a liver hydatid cyst obstructing the inferior vena cava
Title: An intrahepatic cavoportal collateral pathway due to a liver hydatid cyst obstructing the inferior vena cava Authors: Alba Manuel Vázquez, José Manuel Ramia Ángel, Luis Gijón, Roberto de la Plaza
More informationACUTE CHOLANGITIS AS a result of an occluded
Digestive Endoscopy 2017; 29 (Suppl. 2): 88 93 doi: 10.1111/den.12836 Current status of biliary drainage strategy for acute cholangitis Endoscopic treatment for acute cholangitis with common bile duct
More informationENDOSCOPIC TREATMENT OF A BILE DUCT
HPB Surgery, 1990, Vol. 3, pp. 67-71 Reprints available directly from the publisher Photocopying permitted by license only 1990 Harwood Academic Publishers GmbH Printed in the United Kingdom CASE REPORT
More informationIntroduction. Patients and methods. Patients. Background and study aims Failure to recognize the
A simple and novel marking method for correctly identifying the precutting direction to achieve safe and efficacious precut sphincterotomy (with video) Authors Kazumasa Nagai, Akio Katanuma, Kuniyuki Takahashi,
More informationERCP and EUS: What s New and What Should We Do?
ERCP and EUS: What s New and What Should We Do? Rajesh N. Keswani, MD Associate Professor of Medicine Division of Gastroenterology Northwestern University Feinberg School of Medicine EUS/ERCP in 2015 THE
More informationClinical Study Intradiverticular Ampulla of Vater: Personal Experience at ERCP
Diagnostic and Therapeutic Endoscopy Volume 2013, Article ID 102571, 4 pages http://dx.doi.org/10.1155/2013/102571 Clinical Study Intradiverticular Ampulla of Vater: Personal Experience at ERCP Girolamo
More informationAccuracy of ASGE criteria for the prediction of choledocholithiasis
1130-0108/2016/108/6/309-314 Revista Española de Enfermedades Digestivas Copyright 2016 Arán Ediciones, S. L. Rev Esp Enferm Dig (Madrid) Vol. 108, N.º 6, pp. 309-314, 2016 ORIGINAL PAPERS Accuracy of
More informationUnresolved Issues about Post-ERCP Pancreatitis: An Overview
Unresolved Issues about Post-ERCP Pancreatitis: An Overview Pier Alberto Testoni Division of Gastroenterology and Gastrointestinal Endoscopy, University Vita-Salute San Raffaele, IRCCS San Raffaele Hospital.
More informationKouhei Tsuchida *, Mari Iwasaki, Misako Tsubouchi, Tsunehiro Suzuki, Chieko Tsuchida, Naoto Yoshitake, Takako Sasai and Hideyuki Hiraishi
Tsuchida et al. BMC Gastroenterology (2015) 15:59 DOI 10.1186/s12876-015-0290-6 RESEARCH ARTICLE Open Access Comparison of the usefulness of endoscopic papillary large-balloon dilation with endoscopic
More informationEndoscopic Sphincterotomy and Risk of Malignancy in the Bile Ducts, Liver, and Pancreas
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY 2008;6:1049 1053 Endoscopic Sphincterotomy and Risk of Malignancy in the Bile Ducts, Liver, and Pancreas CECILIA STRÖMBERG,* JUHUA LUO, LARS ENOCHSSON,* URBAN ARNELO,*
More informationBiliary tree dilation - and now what?
Biliary tree dilation - and now what? Poster No.: C-1767 Congress: ECR 2012 Type: Educational Exhibit Authors: I. Ferreira, A. B. Ramos, S. Magalhães, M. Certo; Porto/PT Keywords: Pathology, Diagnostic
More informationAdvanced Cannulation Techniques
Advanced Cannulation Techniques Priya A. Jamidar, M.D., FASGE Professor of Medicine, Director of Endoscopy Yale School Disclosures Consultant to Boston Scientific and Olympus America Cannulation at ERCP
More informationSingle-stage management with combined tri-endoscopic approach. approach for concomitant cholecystolithiasis and choledocholithiasis
Surg Endosc (2016) 30:5615 5620 DOI 10.1007/s00464-016-4918-6 and Other Interventional Techniques ENDOLUMINAL SURGERY Single-stage management with combined tri-endoscopic approach for concomitant cholecystolithiasis
More informationIs Endoscopic Retrograde Cholangiopancreatography Safe in Patients 90 Years of Age and Older?
Gut and Liver, Vol. 8, No. 5, September 2014, pp. 552-556 ORiginal Article Is Endoscopic Retrograde Cholangiopancreatography Safe in Patients 90 Years of Age and Older? Dae Young Yun, Jimin Han, Jang Seok
More informationSex-related differences in predicting choledocholithiasis using current American Society of Gastrointestinal Endoscopy risk criteria
ORIGINAL ARTICLE Annals of Gastroenterology (2018) 31, 1-6 Sex-related differences in predicting choledocholithiasis using current American Society of Gastrointestinal Endoscopy risk criteria Ankit Chhoda
More informationsphincterotomy for biliary lithiasis with and without the
Gut, 1984, 25, 598-02 Liver and biliary Early and late complications after endoscopic sphincterotomy for biliary lithiasis with and without the gall bladder 'in situ' J ESCOURROU, J A CORDOVA, F LAZORTHES,
More informationClinical features of gallstone impaction at the ampulla of Vater and the effectiveness of endoscopic biliary drainage without papillotomy
E806 THIEME Clinical features of gallstone impaction at the ampulla of Vater and the effectiveness of endoscopic biliary drainage without Authors Yuichi Takano 1, Masatsugu Nagahama 1, Naotaka Maruoka
More informationCRE Balloon Dilator. DASE Abstract Collection
CRE Balloon Dilator DASE Abstract Collection C o n t e n t s Small Sphincterotomy Combined with Papillary Dilation with Large Balloon Permits Retrieval of Large Stones without Mechanical Lithotripsy....
More informationLong- and short-term outcomes of ERCP for bile duct stones in patients over 80 years old compared to younger patients: a propensity score analysis
THIEME E83 Long- and short-term outcomes of ERCP for bile duct stones in patients over 80 years old compared to younger patients: a propensity score analysis Authors Akira Kanamori, Seiki Kiriyama, Makoto
More informationYoung Hoon Youn Hyun Chul Lim Jae Hoon Jahng Sung Il Jang Jung Hwan You Jung Soo Park Se Joon Lee Dong Ki Lee
Dig Dis Sci (2011) 56:1572 1577 DOI 10.1007/s10620-010-1438-4 ORIGINAL ARTICLE The Increase in Balloon Size to Over 15 mm Does Not Affect the Development of Pancreatitis After Endoscopic Papillary Large
More informationMagnetic Resonance Cholangiopancreatography (MRCP) in a District General Hospital
Magnetic Resonance Cholangiopancreatography (MRCP) in a District General Hospital Poster No.: C-1790 Congress: ECR 2012 Type: Authors: Scientific Exhibit J. A. Maguire 1, H. Kasem 2, M. Akhtar 2, M. Strauss
More informationLarge hydrostatic balloon for choledocolithiasis
1130-0/2007//1/33-3 REVISTA ESPAÑOLA DE ENFERMEDADES DIGESTIVAS Copyright 2007 ARÁN EDICIONES, S. L. REV ESP ENFERM DIG (Madrid) Vol.. N. 1, pp. 33-3, 2007 Large hydrostatic balloon for choledocolithiasis
More informationOUTCOME OF GALL BLADDER IN SITU AFTER ENDOSCOPIC COMMON BILE DUCT STONE REMOVAL: A SINGLE INSTITUTIONAL EXPERIENCE
OUTCOME OF GALL BLADDER IN SITU AFTER ENDOSCOPIC COMMON BILE DUCT STONE REMOVAL: A SINGLE INSTITUTIONAL EXPERIENCE Mohamed A Selima and *Moustafa R Abo Elsoud Department of Clinical and Experimental Surgery,
More informationDuring endoscopic retrograde cholangiopancreatography CLINICAL BILIARY
GASTROENTEROLOGY 2013;144:341 345 CLINICAL BILIARY Randomized Trial of Endoscopic Sphincterotomy With Balloon Dilation Versus Endoscopic Sphincterotomy Alone for Removal of Bile Duct Stones ANTHONY YUEN
More informationTitle: Cholestasis after TIPS placement in a patient with primary sclerosing cholangitis: an uncommon complication
Title: Cholestasis after TIPS placement in a patient with primary sclerosing cholangitis: an uncommon complication Authors: Alejandro Salagre García, Carolina Muñoz Codoceo, Elena Gómez Domínguez, Inmaculada
More informationSPHINCTER OF ODDI DYSFUNCTION (SOD)
SPHINCTER OF ODDI DYSFUNCTION (SOD) Sphincter of Oddi dysfunction refers to structural or functional disorders involving the biliary sphincter that may result in impedance of bile and pancreatic juice
More information7/11/2017. We re gonna help a lot of people today. Biliary/Pancreatic Endoscopy. AGS July 1-2, Kenneth M. Sigman, MD
Biliary/Pancreatic Endoscopy AGS July 1-2, 2017 Kenneth M. Sigman, MD We re gonna help a lot of people today 1 2 3 4 Cannulation It all starts with cannulation Double Wire Cannulation Difficult cannulations
More informationORIGINAL ARTICLE. Larissa University Hospital, Larissa, Greece
ORIGINAL ARTICLE Annals of Gastroenterology (2018) 31, 1-7 Laparoendoscopic rendezvous may be an effective alternative to a failed preoperative endoscopic retrograde cholangiopancreatography in patients
More informationMulticenter retrospective and comparative study of 5-minute versus 15-second endoscopic papillary balloon dilation for removal of bile duct stones
Multicenter retrospective and comparative study of 5-minute versus 15-second endoscopic papillary balloon dilation for removal of bile duct stones Authors Ryunosuke Hakuta 1,2, Tsuyoshi Hamada 1, 3,YousukeNakai
More informationSTRICTURES OF THE BILE DUCTS Session No.: 5. Andrea Tringali Digestive Endoscopy Unit Catholic University Rome - Italy
STRICTURES OF THE BILE DUCTS Session No.: 5 Andrea Tringali Digestive Endoscopy Unit Catholic University Rome - Italy Drainage of biliary strictures. The history before 1980 Surgical bypass Percutaneous
More informationHistory of Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis and Acute Pancreatitis as Risk Factors for Post-ERCP Pancreatitis
Kobe J. Med. Sci., Vol. 63, No. 1, pp. E1-E8, 2017 History of Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis and Acute Pancreatitis as Risk Factors for Post-ERCP Pancreatitis EIJI FUNATSU
More informationTitle: The impact of a percutaneous cholecystostomy catheter in situ until the time of cholecystectomy on the development of recurrent acute
Title: The impact of a percutaneous cholecystostomy catheter in situ until the time of cholecystectomy on the development of recurrent acute cholecystitis: a historical cohort study Authors: Mustafa Hasbahceci,
More informationRole of Therapeutic Endoscopy in Hepatic Hydatid Disease after Surgical Intervention: Case Report
ISPUB.COM The Internet Journal of Gastroenterology Volume 10 Number 2 Role of Therapeutic Endoscopy in Hepatic Hydatid Disease after Surgical Intervention: Case Report H Ono, M Okabe, T Kimura, M Kawakami,
More informationPancreatitis is the most common and potentially serious ENDOSCOPY CORNER
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY 2009;7:834 839 ENDOSCOPY CORNER Short 5Fr vs Long 3Fr Pancreatic Stents in Patients at Risk for Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis
More informationResearch Article Late Complications following Endoscopic Sphincterotomy for Choledocholithiasis: A Swedish Population-Based Study
Diagnostic and erapeutic Endoscopy, Article ID 745790, 5 pages http://dx.doi.org/10.1155/2014/745790 Research Article Late Complications following Endoscopic Sphincterotomy for Choledocholithiasis: A Swedish
More informationNeedle Knife Sphincterotomy Does Not Increase the Risk of Pancreatitis in Patients With Difficult Biliary Cannulation
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY 2013;11:430 436 Needle Knife Sphincterotomy Does Not Increase the Risk of Pancreatitis in Patients With Difficult Biliary Cannulation MICHAEL P. SWAN, SINA ALEXANDER,
More informationMaking ERCP Easy: Tips From A Master
Making ERCP Easy: Tips From A Master Raj J. Shah, M.D., FASGE Associate Professor of Medicine University of Colorado School of Medicine Co-Director, Endoscopy Director, Pancreaticobiliary Endoscopy Services
More informationPerforations Occurring during ERCP: A Complication to Take into Account
Case report Perforations Occurring during ERCP: A Complication to Take into Account Martín Alonso Gómez Zuleta, MD, 1 David Andrés Viveros Carreño, MD. 2 1 Gastroenterology Unit at the Universidad Nacional
More informationTHE AMERICAN JOURNAL OF GASTROENTEROLOGY Vol. 96, No. 10, by Am. Coll. of Gastroenterology ISSN /01/$20.00
THE AMERICAN JOURNAL OF GASTROENTEROLOGY Vol. 96, No. 10, 2001 2001 by Am. Coll. of Gastroenterology ISSN 0002-9270/01/$20.00 Published by Elsevier Science Inc. PII S0002-9270(01)02807-6 Can Endoscopic
More informationCholecystectomy for Prevention of Recurrence after Endoscopic Clearance of Bile Duct Stones in Korea
Original Article Yonsei Med J 2016 Jan;57(1):132-137 pissn: 0513-5796 eissn: 1976-2437 Cholecystectomy for Prevention of Recurrence after Endoscopic Clearance of Bile Duct Stones in Korea Myung Eun Song,
More informationOriginal Policy Date 12:2013
MP 6.01.30 Magnetic Resonance Cholangiopancreatography Medical Policy Section Radiology Is12:2013sue 3:2005 Original Policy Date 12:2013 Last Review Status/Date 12:2013 Return to Medical Policy Index Disclaimer
More informationCongenital dilatation of the common bile duct and pancreaticobiliary maljunction clinical implications
Langenbecks Arch Surg (2009) 394:209 213 DOI 10.1007/s00423-008-0330-6 CURRENT CONCEPT IN CLINICAL SURGERY Congenital dilatation of the common bile duct and pancreaticobiliary maljunction clinical implications
More informationManagement of the Mucin Filled Bile Duct. A Complication of Intraductal Papillary Mucinous Tumor of the Pancreas
CASE REPORT Management of the Mucin Filled Bile Duct. A Complication of Intraductal Papillary Mucinous Tumor of the Pancreas Anand Patel, Louis Lambiase, Antonio Decarli, Ali Fazel Division of Gastroenterology
More informationEndoscopic biliary self-expandable metallic stent in malignant biliary obstruction with or without sphincterotomy: systematic review and meta-analysis
Review Endoscopic biliary self-expandable metallic in malignant biliary obstruction with or without sphincterotomy: systematic review and meta-analysis Authors Benedetto Mangiavillano 1, 2, Amedeo Montale
More informationERCP complications and challenges in their diagnosis and management.
ERCP complications and challenges in their diagnosis and management. Sandie R Thomson Chair of the Division of Gastroenterology, University of Cape Town ERCP Do I have a good Indication? . Algorithm for
More informationBILIARY CANNULATION FOR the treatment of biliary
Digestive Endoscopy 2016; 28 (Suppl. 1): 96 101 doi: 10.1111/den.12611 Current situation of cannulation and salvage for difficult cases Endoscopic ultrasonography-guided rendezvous technique Takayoshi
More informationLIVER, PANCREAS, AND BILIARY TRACT
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY 2012;10:1157 1161 LIVER, PANCREAS, AND BILIARY TRACT Delayed and Unsuccessful Endoscopic Retrograde Cholangiopancreatography Are Associated With Worse Outcomes
More informationClinical Practice KPBA Guideline for Common Bile Duct Stones: The Endoscopic Management of Difficult and Recurrent Common Bile Duct Stones
PBS-I Pancreatobiliary Endoscopist's Rule of Thumb Clinical Practice KPBA Guideline for Common Bile Duct Stones: The Endoscopic Management of Difficult and Recurrent Common Bile Duct Stones Byung Moo Yoo,
More informationClinical Study Covered Metal Stenting for Malignant Lower Biliary Stricture with Pancreatic Duct Obstruction: Is Endoscopic Sphincterotomy Needed?
Gastroenterology Research and Practice Volume 2013, Article ID 375613, 6 pages http://dx.doi.org/10.1155/2013/375613 Clinical Study Covered Metal Stenting for Malignant Lower Biliary Stricture with Pancreatic
More informationTHE DIAGNOSTIC ACCURACY OF RAISED SERUM AMYLASE LEVEL AT 4 HOURS POST ERCP IN PREDICTING ACUTE PANCREATITIS
ORIGINAL ARTICLE THE DIAGNOSTIC ACCURACY OF RAISED SERUM AMYLASE LEVEL AT 4 HOURS POST ERCP IN PREDICTING ACUTE PANCREATITIS UMBREEN ASLAM KHAN, SABEEN FARHAN, MUHAMMAD ARIF NADEEM, SIDRA RASHEED Department
More informationRole of hepatobiliary ultrasound in the diagnosis of choledocolitiasis
Original articles Role of hepatobiliary ultrasound in the diagnosis of choledocolitiasis Andrea Piña, MD, 1 Martín Garzón, MD, 1 Jorge Iván Lizarazo, MD, 1 Juan Carlos Marulanda, MD, 1 Juan Carlos Molano,
More informationImpact of Periampullary Diverticulum on ERCP Performance: A Matched Case-Control Study
ORIGINAL ARTICLE 2018 Aug 21. [Epub ahead of print] https://doi.org/10.5946/ce.2018.070 Print ISSN 2234-2400 On-line ISSN 2234-2443 Open Access Impact of Periampullary Diverticulum on ERCP Performance:
More informationHaving a Stent Placed at ERCP
Having a Stent Placed at ERCP Information for patients, relatives and carers This information leaflet should be read in conjunction with the ERCP information booklet (ref PIL 78) Endoscopy Unit For more
More information6/17/2016. ERCP in June 26, Kenneth M. Sigman, M.D. Birmingham Gastroenterology Associates
ERCP in 2016 June 26, 2016 Kenneth M. Sigman, M.D. Birmingham Gastroenterology Associates 1 2 3 Diagnostic/Therapeutic ERCP Biliary Obstruction Benign stricture Malignant Stones Ductal injuries Cholangitis
More informationEndoscopic Retrograde Pancreatography and Laparoscopic Cholecystectomy. TEAM 1 Janix M. De Guzman, MD Presentor
Endoscopic Retrograde Pancreatography and Laparoscopic Cholecystectomy TEAM 1 Janix M. De Guzman, MD Presentor Premise 40F Jaundice Abdominal pain US finding of gallstones with apparently normal common
More informationTitle: Utility of neoadjuvant therapy in rectal GIST. Authors: Víctor López-López, Juan Ángel Fernández, Pascual Parrilla
Title: Utility of neoadjuvant therapy in rectal GIST Authors: Víctor López-López, Juan Ángel Fernández, Pascual Parrilla DOI: 10.17235/reed.2017.4751/2016 Link: PubMed (Epub ahead of print) Please cite
More informationWe are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists. International authors and editors
We are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists 3,700 108,500 1.7 M Open access books available International authors and editors Downloads Our
More informationWhat can you expect after your ERCP?
ERCP Explained and respond to bed rest, pain relief and fasting to rest the gut with the patient needing to stay in hospital for only a few days. Some patients develop severe pancreatitis and may require
More informationClinical Study Utility and Safety of ERCP in the Elderly: A Comparative Study in Iran
Hindawi Publishing Corporation Diagnostic and Therapeutic Endoscopy Volume 2012, Article ID 439320, 5 pages doi:10.1155/2012/439320 Clinical Study Utility and Safety of ERCP in the Elderly: A Comparative
More informationT-TUBE DRAINAGE VERSUS PRIMARY COMMON BILE DUCT CLOSURE AFTER OPEN CHOLEDOCHOTOMY
T-TUBE DRAINAGE VERSUS PRIMARY COMMON BILE DUCT CLOSURE AFTER OPEN CHOLEDOCHOTOMY Khaled Ahmed El- Dabee, Abd Al-Lateif Ahmed, Mohamed Abdel Aziz Abdel Jawad, Taha Bahgat Salam, Ahmed Eisa Ahmed* and Saed
More informationThe Incidence of Complications in Single-stage Endoscopic Stone Removal for Patients with Common Bile Duct Stones: A Propensity Score Analysis
doi: 10.2169/internalmedicine.9123-17 http://internmed.jp ORIGINAL ARTICLE The Incidence of Complications in Single-stage Endoscopic Stone Removal for Patients with Common Bile Duct Stones: A Propensity
More informationTools of the Gastroenterologist: Introduction to GI Endoscopy
Tools of the Gastroenterologist: Introduction to GI Endoscopy Objectives Endoscopy Upper endoscopy Colonoscopy Endoscopic retrograde cholangiopancreatography (ERCP) Endoscopic ultrasound (EUS) Endoscopic
More informationA cute pancreatitis is a common complication of endoscopic
1768 PANCREAS Intravenous bolus somatostatin after diagnostic cholangiopancreatography reduces the incidence of pancreatitis associated with therapeutic endoscopic retrograde cholangiopancreatography procedures:
More informationThe Use of Pancreatoscopy in the Diagnosis of Intraductal Papillary Mucinous Tumor Lesions of the Pancreas
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY 2005;3:S53 S57 The Use of Pancreatoscopy in the Diagnosis of Intraductal Papillary Mucinous Tumor Lesions of the Pancreas KENJIRO YASUDA, MUNEHIRO SAKATA, MOOSE
More informationNaoyuki Toyota, Tadahiro Takada, Hodaka Amano, Masahiro Yoshida, Fumihiko Miura, and Keita Wada
J Hepatobiliary Pancreat Surg (2006) 13:80 85 DOI 10.1007/s00534-005-1062-4 Endoscopic naso-gallbladder drainage in the treatment of acute cholecystitis: alleviates inflammation and fixes operator s aim
More informationAseries of credentialing guidelines for gastrointestinal endoscopic
CURRENT ENDOSCOPIC PRACTICES THE EXPERTS SPEAK Canadian credentialing guidelines for endoscopic retrograde cholangiopancreatography Jonathon Springer MD FRCPC 1, Robert Enns MD FRCPC 2, Joseph Romagnuolo
More informationEndoscopic Management of the Iatrogenic CBD Injury
The Liver Week 2014, Jeju, Korea Endoscopic Management of the Iatrogenic CBD Injury Jong Ho Moon, MD, PhD Department of Internal Medicine Soon Chun Hyang University School of Medicine Bucheon/Seoul, KOREA
More informationCase Rep Gastroenterol 2010;4:71 78 DOI: /
71 Gallstone Ileus, Bouveret s Syndrome and Choledocholithiasis in a Patient with Billroth II Gastrectomy A Case Report of Combined Endoscopic and Surgical Therapy R. Fejes G. Kurucsai A. Székely F. Luka
More informationGEEW June 20-22, 2016 Brussels.
GEEW June 20-22, 2016 Brussels www.live-endoscopy.com Selective biliary cannulation Jacques Devière, MD, PhD Erasme Hospital Université Libre de Bruxelles Brussels, Belgium Cannulation of the Papilla Opacification
More informationBile Duct Injury during Lap Chole. Bile Duct Injury during cholecystectomy TOPICS. 1. Prevalence, mechanisms, prevention and diagnosis
Bile Duct Injury during cholecystectomy Catherine HUBERT Jean-Fran François GIGOT Benoît t NAVEZ Division of Hepato-Biliary Biliary-Pancreatic Surgery Department of Abdominal Surgery and Transplantation
More informationCholangiocarcinoma (Bile Duct Cancer)
Cholangiocarcinoma (Bile Duct Cancer) The Bile Duct System (Biliary Tract) A network of bile ducts (tubes) connects the liver and the gallbladder to the small intestine. This network begins in the liver
More informationPrevention and management of complications
Prevention and management of complications Endoscopic retrograde cholangiopancreatography (ERCP) H.-J. Schulz, H. Schmidt Oskar-Ziethen-Hospital Sana Clinic Lichtenberg Teaching Hospital of Charité Humboldt
More informationA Guide for Patients Living with a Biliary Metal Stent
A Guide for Patients Living with a Biliary Metal Stent What is a biliary metal stent? A biliary metal stent (also known as a bile duct stent ) is a flexible metallic tube specially designed to hold your
More informationstents she/he is providing appropriate or inappropriate care?
Pancreatic Stents Are They Now State of the Art Care? To Help Limit Post ERCP Pancreatitis Glen A. Lehman, M.D. Professor of Medicine and Radiology Division of Gastroenterology/Hepatology Indiana University
More information2014 Deleted CPT Codes
2014 Deleted CPT Codes Surgery 13150 - Repair, complex, eyelids, nose, ears and/or lips; 1.0 cm or less 19102 - Biopsy of breast; percutaneous, needle core, using imaging guidance 19103 - Biopsy of breast;
More informationResearch Article The Diagnostic Accuracy of Linear Endoscopic Ultrasound for Evaluating Symptoms Suggestive of Common Bile Duct Stones
Gastroenterology Research and Practice Volume 2016, Article ID 6957235, 5 pages http://dx.doi.org/10.1155/2016/6957235 Research Article The Diagnostic Accuracy of Linear Endoscopic Ultrasound for Evaluating
More informationPOST-CHOLECYSTECTOMY COMPLICATIONS AND ERCP
Original article POST-CHOLECYSTECTOMY COMPLICATIONS AND ERCP AA Durrani 1, Nayyar Yaqoob 2, Zubair Hussan 3, Masood Siddique 4, Shaeen Moin 5, MM Mufti 6, Ashraf A Malhi 7 ABSTRACT Objective: To document
More informationDirect peroral cholangioscopy using an ultrathin endoscope: Making technique easier
1130-0108/2014/106/1/30-36 Revista Española de Enfermedades Digestivas Copyright 2014 Arán Ediciones, S. L. Rev Esp Enferm Dig (Madrid Vol. 106, N.º 1, pp. 30-36, 2014 ORIGINAL PAPERS Direct peroral cholangioscopy
More informationRESEARCH ARTICLE. Clinical Efficacy of Endoscopic Pancreatic Drainage for Pain Relief with Malignant Pancreatic Duct Obstruction
DOI:http://dx.doi.org/10.7314/APJCP.2014.15.16.6823 RESEARCH ARTICLE Clinical Efficacy of Endoscopic Pancreatic Drainage for Pain Relief with Malignant Pancreatic Duct Obstruction Fei Gao 1 *, Shuren Ma
More informationGallstones. Classification
Gallstones Nariman Karanjia Tahir Ali Abstract Gallstones are extremely common in the UK and have a major effect on healthcare resources. Presentation depends on whether the stones occlude the cystic duct
More informationPapillary cannulation and sphincterotomy techniques at ERCP: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline
Guideline 657 Papillary and sphincterotomy techniques at ERCP: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline Authors Pier Alberto Testoni 1, Alberto Mariani 1, Lars Aabakken
More informationCase Report Uncommon Mixed Type I and II Choledochal Cyst: An Indonesian Experience
Case Reports in Surgery Volume 2013, Article ID 821032, 4 pages http://dx.doi.org/10.1155/2013/821032 Case Report Uncommon Mixed Type I and II Choledochal Cyst: An Indonesian Experience Fransisca J. Siahaya,
More information