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Endoscopic Interventions for the Early and Remission Phases of Acute Biliary Pancreatitis: What are the More Concrete and Practical Situations for Performing Them?
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Sho Hasegawa, Shinsuke Koshita, Yoshihide Kanno, Takahisa Ogawa, Toshitaka Sakai, Hiroaki Kusunose, Kensuke Kubota, Atsushi Nakajima, Yutaka Noda, Kei Ito
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Clin Endosc 2021;54(6):888-898. Published online May 27, 2021
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DOI: https://doi.org/10.5946/ce.2020.271
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 Abstract
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- Background
/Aims: The use of endoscopic intervention (EI) for acute biliary pancreatitis (ABP) remains controversial because the severity of biliary obstruction/cholangitis/pancreatitis is not reflected in the indications for early EI (EEI).
Methods
A total of 148 patients with ABP were included to investigate 1) the differences in the rate of worsening cholangitis/pancreatitis between the EEI group and the early conservative management (ECM) group, especially for each severity of cholangitis/pancreatitis, and 2) the diagnostic ability of imaging studies, including endoscopic ultrasound (EUS), to detect common bile duct stones (CBDSs) in the ECM group.
Results
No differences were observed in the rate of worsening cholangitis between the EEI and ECM groups, regardless of the severity of cholangitis and/or the existence of impacted CBDSs. Among patients without impacted CBDSs and moderate/severe cholangitis, worsening pancreatitis was significantly more frequent in the EEI group (18% vs. 4%, p=0.048). In patients in the ECM group, the sensitivity and specificity for detecting CBDSs were 73% and 98%, respectively, for EUS, whereas the values were 13% and 92%, respectively, for magnetic resonance cholangiopancreatography.
Conclusions
EEI should be avoided in the absence of moderate/severe cholangitis and/or impacted CBDSs because of the high rate of worsening pancreatitis. EUS can contribute to the accurate detection of residual CBDSs, for the determination of the need for elective EI.
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Capability of Radial- and Convex-Arrayed Echoendoscopes for Visualization of the Pancreatobiliary Junction
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Yoshihide Kanno, Kei Ito, Shinsuke Koshita, Takahisa Ogawa, Hiroaki Kusunose, Kaori Masu, Toshitaka Sakai, Toji Murabayashi, Sho Hasegawa, Fumisato Kozakai, Yujiro Kawakami, Yuki Fujii, Yutaka Noda
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Clin Endosc 2018;51(3):274-278. Published online September 25, 2017
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DOI: https://doi.org/10.5946/ce.2017.098
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Abstract
PDFPubReaderePub
- Background
/Aims: Although both radial- and convex-arrayed endoscopic ultrasonography (EUS) scopes are widely used for observational EUS examinations, there have been few comparative studies on their power of visualization. The aim of this study was to evaluate the capability of these EUS scopes for observation of the pancreatobiliary junction.
Methods
The rate of successful visualization of the pancreatobiliary junction was retrospectively compared between a radial-arrayed and a convex-arrayed echoendoscope, from a prospectively maintained database. Study periods were defined as January 2010 to December 2012 for the radial group, and February 2015 to October 2016 for the convex group because the respective scope was mainly used during those periods.
Results
During the study period, 1,660 cases with radial EUS and 1,984 cases with convex EUS were recruited. The success rates of observation of the pancreatobiliary junction were 80.0% and 89.5%, respectively (p<0.0001).
Conclusions
The capability of visualization of the pancreatobiliary junction in observational EUS was found to be better with a convex-arrayed than with a radial-arrayed echoendoscope.
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Citations
Citations to this article as recorded by  - Incidental findings of gallbladder and bile ducts – Management strategies: Normal findings, anomalies, “silent gallstones” and bile duct dilatation - A World Federation of Ultrasound in Medicine and Biology (WFUMB) position paper
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Kathleen Möller, Christian Jenssen, André Ignee, Michael Hocke, Siegbert Faiss, Julio Iglesias-Garcia, Siyu Sun, Yi Dong, Christoph F. Dietrich
Endoscopic Ultrasound.2023; 12(2): 200. CrossRef - Linear-array EUS improves the accuracy of predicting deep submucosal invasion in non-pedunculated rectal polyps compared with radial EUS: a prospective observational study
Zhixian Lan, Kangyue Sun, Yuchen Luo, Haiyan Hu, Wei Zhu, Wen Guo, Jing Wen, Wenting Mi, Junsheng Chen, Xiang Chen, Venkata Akshintala, Ying Huang, Side Liu, Yue Li
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