AZM： To evaluate our experience in endoscopic retrograde cholangio-pancreatography （ERCP） in terms of fulfilling the ASGE guidelines in indications, positive findings, and complications in the post-magnetic resonan...AZM： To evaluate our experience in endoscopic retrograde cholangio-pancreatography （ERCP） in terms of fulfilling the ASGE guidelines in indications, positive findings, and complications in the post-magnetic resonance cholangiopancreatography （MRCP） era. METHODS： Between November 2001 and February 2003, consecutive ERCP cases were prospectively evaluated with regard to the indications, findings, cannulation techniques, devices used during the procedure, sedation given, duration of procedure, and complications. These data were entered in a database for subsequent processing and analysis. RESULTS： Of 336 cases, 21.4% were diagnostic and 78.6% therapeutic ERCR The indications for ERCP fulfilled the ASGE guidelines in 323 cases （96.1%）. Suspected bile duct stone was the most frequent indication （26.8%）, and this was followed by cholangitis （24.4%）, dilated common bile duct （14.9%）, and cholestatic jaundice （23.4%）. Cannulation success rate was 94%. Biliary sphincterotomy was performed in 175 （52.1%） patients. Repeated ERCP was performed on 31.5% of the patients. Overall, the complication rate was 9.8% with 0.3% being procedurerelated mortality. The complications were pancreatitis （5.4%）, bleeding （0.8%）, cholangitis （2.4%） and others （1.5%）. No significant difference was observed between the complication rate and the type of ERCP performed. CONCLUSION： Our study showed that post-ERCP complication rate was comparable with the other large prospective studies and there was no difference in the complication between the diagnostic and therapeutic ERCP.展开更多
AIM: To validate the accuracy of four rapid blood tests in the diagnosis of Helicobacter pylori.METHODS: Consecutive dyspeptic patients scheduled for endoscopy at the National University Hospital,Singapore, were inter...AIM: To validate the accuracy of four rapid blood tests in the diagnosis of Helicobacter pylori.METHODS: Consecutive dyspeptic patients scheduled for endoscopy at the National University Hospital,Singapore, were interviewed and had blood drawn for serology. The first 109 patients were tested with BM-test (BM), Pyloriset Screen (PS) and QuickVue (QV), and the next 99 subjects were tested with PS and Unigold (UG).Endoscopies were performed blinded to rapid blood test results and biopsies were taken for culture and rapid urease test. Urea breath tests were performed after endoscopies. The rapid blood test results were compared with four reference tests (rapid urease test, culture,serology, and breath test).RESULTS: The study population composed of 208patients (mean age 43.1 years; range 18-73 years; 119males; 174 Chinese). The number of evaluable patientsfor BM, QV, UG and PS were 102, 102, 95, and 197,respectively. The sensitivity and specificity, respectively were: PS 80.2%, 95.8%; UG 55.9%, 100%; QV 43.3%,100%; BM 67.2%, 97.1%.CONCLUSION: The rapid blood test kits showed high specificity and positive predictive value (97-100%), while sensitivity and negative predictive value ranged widely (43%-80% and 47%-73%, respectively). Among test kits, PS showed the best sensitivity (80%), best negative predictive value (73%) and best negative likelihood ratio (0.207). PS had a specificity of 96%, positive predictive value of 97% and positive likelihood ratio of 19.1.展开更多
文摘AZM： To evaluate our experience in endoscopic retrograde cholangio-pancreatography （ERCP） in terms of fulfilling the ASGE guidelines in indications, positive findings, and complications in the post-magnetic resonance cholangiopancreatography （MRCP） era. METHODS： Between November 2001 and February 2003, consecutive ERCP cases were prospectively evaluated with regard to the indications, findings, cannulation techniques, devices used during the procedure, sedation given, duration of procedure, and complications. These data were entered in a database for subsequent processing and analysis. RESULTS： Of 336 cases, 21.4% were diagnostic and 78.6% therapeutic ERCR The indications for ERCP fulfilled the ASGE guidelines in 323 cases （96.1%）. Suspected bile duct stone was the most frequent indication （26.8%）, and this was followed by cholangitis （24.4%）, dilated common bile duct （14.9%）, and cholestatic jaundice （23.4%）. Cannulation success rate was 94%. Biliary sphincterotomy was performed in 175 （52.1%） patients. Repeated ERCP was performed on 31.5% of the patients. Overall, the complication rate was 9.8% with 0.3% being procedurerelated mortality. The complications were pancreatitis （5.4%）, bleeding （0.8%）, cholangitis （2.4%） and others （1.5%）. No significant difference was observed between the complication rate and the type of ERCP performed. CONCLUSION： Our study showed that post-ERCP complication rate was comparable with the other large prospective studies and there was no difference in the complication between the diagnostic and therapeutic ERCP.
文摘AIM: To validate the accuracy of four rapid blood tests in the diagnosis of Helicobacter pylori.METHODS: Consecutive dyspeptic patients scheduled for endoscopy at the National University Hospital,Singapore, were interviewed and had blood drawn for serology. The first 109 patients were tested with BM-test (BM), Pyloriset Screen (PS) and QuickVue (QV), and the next 99 subjects were tested with PS and Unigold (UG).Endoscopies were performed blinded to rapid blood test results and biopsies were taken for culture and rapid urease test. Urea breath tests were performed after endoscopies. The rapid blood test results were compared with four reference tests (rapid urease test, culture,serology, and breath test).RESULTS: The study population composed of 208patients (mean age 43.1 years; range 18-73 years; 119males; 174 Chinese). The number of evaluable patientsfor BM, QV, UG and PS were 102, 102, 95, and 197,respectively. The sensitivity and specificity, respectively were: PS 80.2%, 95.8%; UG 55.9%, 100%; QV 43.3%,100%; BM 67.2%, 97.1%.CONCLUSION: The rapid blood test kits showed high specificity and positive predictive value (97-100%), while sensitivity and negative predictive value ranged widely (43%-80% and 47%-73%, respectively). Among test kits, PS showed the best sensitivity (80%), best negative predictive value (73%) and best negative likelihood ratio (0.207). PS had a specificity of 96%, positive predictive value of 97% and positive likelihood ratio of 19.1.
