Acute post-endoscopic retrograde cholangiopancreatography pancreatitis(PEP)is a feared and potentially fatal complication that can be as high as up to 30%in high-risk patients.Pre-examination measures,during the exami...Acute post-endoscopic retrograde cholangiopancreatography pancreatitis(PEP)is a feared and potentially fatal complication that can be as high as up to 30%in high-risk patients.Pre-examination measures,during the examination and after the examination are the key to technical and clinical success with a decrease in adverse events.Several studies have debated on the subject,however,numerous topics remain controversial,such as the effectiveness of prophylactic medications and the amylase dosage time.This review was designed to provide an update on the current scientific evidence regarding PEP available in the literature.展开更多
AIM To compare the cannulation success, biochemical profile, and complications of the papillary fistulotomy technique vs catheter and guidewire standard access.METHODS From July 2010 to May 2017, patients were prospec...AIM To compare the cannulation success, biochemical profile, and complications of the papillary fistulotomy technique vs catheter and guidewire standard access.METHODS From July 2010 to May 2017, patients were prospectively randomized into two groups: Cannulation with a catheter and guidewire(Group Ⅰ) and papillary fistulotomy(Group Ⅱ). Amylase, lipase and C-reactive protein at T0, as well as 12 h and 24 h after endoscopic retrograde cholangiopancreatography, and complications(pancreatitis, bleeding, perforation) were recorded.RESULTS We included 102 patients(66 females and 36 males, mean age 59.11 ± 18.7 years). Group Ⅰ and Group Ⅱ had 51 patients each. The successful cannulation rates were 76.5% and 100%, respectively(P = 0.0002). Twelve patients(23.5%) in Group Ⅰ had a difficult cannulation and underwent fistulotomy, which led to successful secondary biliary access(Failure Group). The complication rate was 13.7%(2 perforations and 5 mild pancreatitis) vs 2.0%(1 patient with perforation and pancreatitis) in Groups Ⅰ and Ⅱ, respectively(P = 0.0597). CONCLUSION Papillary fistulotomy was more effective than guidewire cannulation, and it was associated with a lower profile of amylase and lipase. Complications were similar in both groups.展开更多
文摘Acute post-endoscopic retrograde cholangiopancreatography pancreatitis(PEP)is a feared and potentially fatal complication that can be as high as up to 30%in high-risk patients.Pre-examination measures,during the examination and after the examination are the key to technical and clinical success with a decrease in adverse events.Several studies have debated on the subject,however,numerous topics remain controversial,such as the effectiveness of prophylactic medications and the amylase dosage time.This review was designed to provide an update on the current scientific evidence regarding PEP available in the literature.
文摘AIM To compare the cannulation success, biochemical profile, and complications of the papillary fistulotomy technique vs catheter and guidewire standard access.METHODS From July 2010 to May 2017, patients were prospectively randomized into two groups: Cannulation with a catheter and guidewire(Group Ⅰ) and papillary fistulotomy(Group Ⅱ). Amylase, lipase and C-reactive protein at T0, as well as 12 h and 24 h after endoscopic retrograde cholangiopancreatography, and complications(pancreatitis, bleeding, perforation) were recorded.RESULTS We included 102 patients(66 females and 36 males, mean age 59.11 ± 18.7 years). Group Ⅰ and Group Ⅱ had 51 patients each. The successful cannulation rates were 76.5% and 100%, respectively(P = 0.0002). Twelve patients(23.5%) in Group Ⅰ had a difficult cannulation and underwent fistulotomy, which led to successful secondary biliary access(Failure Group). The complication rate was 13.7%(2 perforations and 5 mild pancreatitis) vs 2.0%(1 patient with perforation and pancreatitis) in Groups Ⅰ and Ⅱ, respectively(P = 0.0597). CONCLUSION Papillary fistulotomy was more effective than guidewire cannulation, and it was associated with a lower profile of amylase and lipase. Complications were similar in both groups.
