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Funded articles
Systematic Review and Meta-analysis
Coaxial plastic stent placement within lumen-apposing metal stents for the management of pancreatic fluid collections: a systemic review and meta-analysis
Jad AbiMansour, Veeravich Jaruvongvanich, Saran Velaga, Ryan Law, Andrew C. Storm, Mark Topazian, Michael J. Levy, Ryan Alexander, Eric J. Vargas, Aliana Bofill-Garica, John A. Martin, Bret T. Petersen, Barham K. Abu Dayyeh, Vinay Chandrasekhara
Clin Endosc 2024;57(5):595-603.   Published online July 24, 2024
DOI: https://doi.org/10.5946/ce.2023.297
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background
/Aims: Coaxial placement of double pigtail plastic stents (DPPS) through lumen-apposing metal stents (LAMSs) is commonly performed to reduce the risk of LAMS obstruction, bleeding, and stent migration when used for the drainage of pancreatic fluid collections (PFCs). A systematic review and meta-analysis were performed to compare the outcomes of LAMS alone and LAMS with coaxial DPPS placement in the management of PFCs.
Methods
A systematic review was conducted to identify studies comparing LAMS and LAMS/DPPS for PFC drainage. Primary outcomes included the rate of clinical success, overall adverse events (AEs), bleeding, infection, occlusion, and stent migration. The pooled effect size was summarized using a random-effects model and compared between LAMS and LAMS/DPPS by calculating odds ratios (ORs).
Results
Nine studies involving 709 patients were identified (338 on LAMS and 371 on LAMS/DPPS). LAMS/DPPS was associated with a reduced risk of stent obstruction (OR, 0.59; p=0.004) and infection (OR, 0.55; p=0.001). No significant differences were observed in clinical success (OR, 0.96; p=0.440), overall AEs (OR, 0.57; p=0.060), bleeding (OR, 0.61; p=0.120), or stent migration (OR, 1.03; p=0.480).
Conclusions
Coaxial DPPS for LAMS drainage of PFCs is associated with a reduced risk of stent occlusion and infection; however, no difference was observed in the overall AE rates or bleeding.
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Original Articles
Synergistic effect of independent risk factors for post-endoscopic retrograde cholangiopancreatography pancreatitis: a multicenter retrospective study in Japan
Hirokazu Saito, Yoshihiro Kadono, Takashi Shono, Kentaro Kamikawa, Atsushi Urata, Jiro Nasu, Masayoshi Uehara, Ikuo Matsushita, Tatsuyuki Kakuma, Shunpei Hashigo, Shuji Tada
Clin Endosc 2024;57(4):508-514.   Published online April 18, 2024
DOI: https://doi.org/10.5946/ce.2023.203
Graphical AbstractGraphical Abstract AbstractAbstract PDFPubReaderePub
Background
/Aims: This study aimed to examine the synergistic effect of independent risk factors on post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP).
Methods
This multicenter retrospective study included 1,273 patients with native papillae who underwent ERCP for bile duct stones in Japan. Independent PEP risk factors were identified using univariate and multivariate analyses. Significant risk factors for PEP in the multivariate analysis were included in the final analysis to examine the synergistic effect of independent risk factors for PEP.
Results
PEP occurred in 45 of 1,273 patients (3.5%). Three factors including difficult cannulation ≥10 minutes, pancreatic injection, and normal serum bilirubin level were included in the final analysis. The incidences of PEP in patients with zero, one, two, and three factors were 0.5% (2/388), 1.9% (9/465), 6.0% (17/285), and 12.6% (17/135), respectively. With increasing risk factors for PEP, the incidence of PEP significantly increased (1 factor vs. 2 factors, p=0.006; 2 factors vs. 3 factors, p=0.033).
Conclusions
As the number of risk factors for PEP increases, the risk of PEP may not be additive; however, it may multiply. Thus, aggressive prophylaxis for PEP is strongly recommended in patients with multiple risk factors.

Citations

Citations to this article as recorded by  
  • Risk factors for acute pancreatitis after endoscopic retrograde cholangiopancreatography: a retrospective single-center study
    I.М. Mamontov, D.D. Rjabushhenko, Т.І. Tamm, К.О. Kramarenko, V.V. Nepomniashchyi, A.T. Ustinov
    Український радіологічний та онкологічний журнал.2024; 32(3): 287.     CrossRef
  • 2,819 View
  • 163 Download
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Double-guidewire technique for selective biliary cannulation does not increase the rate of post-endoscopic retrograde cholangiopancreatography pancreatitis in patients with naïve papilla
Han Taek Jeong, June Hwa Bae, Ho Gak Kim, Jimin Han
Clin Endosc 2024;57(2):226-236.   Published online January 26, 2024
DOI: https://doi.org/10.5946/ce.2023.128
Graphical AbstractGraphical Abstract AbstractAbstract PDFPubReaderePub
Background
/Aims: This study aimed to compare the safety of the double-guidewire technique (DGT) with that of the conventional single-guidewire technique (SGT) in real-world situations.
Methods
A total of 240 patients with naïve papilla who underwent endoscopic retrograde cholangiopancreatography (ERCP) at Daegu Catholic University Medical Center between January 2021 and December 2021 were included. The primary outcome was the rate of post-ERCP pancreatitis (PEP) in the SGT and DGT groups.
Results
A total of 163 patients (67.9%) belonged to the SGT group, and 77 (32.1%) belonged to the DGT group. The rates of successful biliary cannulation were 95.7% and 83.1% in the SGT and DGT groups, respectively (p=0.002). In the study group, PEP occurred in 14 patients (5.8%). The PEP rates were not significantly different between the SGT and DGT groups (4.3% vs. 9.1%, p=0.150). In the multivariate analysis, the age of <50 years (odds ratio [OR], 9.305; 95% confidence interval [CI], 1.367–63.358; p=0.023) and hyperlipidemia (OR, 7.384; 95% CI, 1.103–49.424; p=0.039) were significant risk factors for PEP in the DGT group.
Conclusions
DGT did not increase the PEP rate in patients with naïve papilla. In addition, the age of <50 years and hyperlipidemia were significant risk factors for PEP in the DGT group.
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Review
Endoscopic retrograde cholangiopancreatography-related complications: risk stratification, prevention, and management
Clement Chun Ho Wu, Samuel Jun Ming Lim, Christopher Jen Lock Khor
Clin Endosc 2023;56(4):433-445.   Published online July 17, 2023
DOI: https://doi.org/10.5946/ce.2023.013
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Endoscopic retrograde cholangiopancreatography (ERCP) plays a crucial role in the management of pancreaticobiliary disorders. Although the ERCP technique has been refined over the past five decades, it remains one of the endoscopic procedures with the highest rate of complications. Risk factors for ERCP-related complications are broadly classified into patient-, procedure-, and operator-related risk factors. Although non-modifiable, patient-related risk factors allow for the closer monitoring and instatement of preventive measures. Post-ERCP pancreatitis is the most common complication of ERCP. Risk reduction strategies include intravenous hydration, rectal nonsteroidal anti-inflammatory drugs, and pancreatic stent placement in selected patients. Perforation is associated with significant morbidity and mortality, and prompt recognition and treatment of ERCP-related perforations are key to ensuring good clinical outcomes. Endoscopy plays an expanding role in the treatment of perforations. Specific management strategies depend on the location of the perforation and the patient’s clinical status. The risk of post-ERCP bleeding can be attenuated by preprocedural optimization and adoption of intra-procedural techniques. Endoscopic measures are the mainstay of management for post-ERCP bleeding. Escalation to angioembolization or surgery may be required for refractory bleeding. Post-ERCP cholangitis can be reduced with antibiotic prophylaxis in high risk patients. Bile culture-directed therapy plays an important role in antimicrobial treatment.

Citations

Citations to this article as recorded by  
  • Prevention of post-ERCP complications
    Lotfi Triki, Andrea Tringali, Marianna Arvanitakis, Tommaso Schepis
    Best Practice & Research Clinical Gastroenterology.2024; 69: 101906.     CrossRef
  • International Digestive Endoscopy Network consensus on the management of antithrombotic agents in patients undergoing gastrointestinal endoscopy
    Seung Joo Kang, Chung Hyun Tae, Chang Seok Bang, Cheol Min Shin, Young-Hoon Jeong, Miyoung Choi, Joo Ha Hwang, Yutaka Saito, Philip Wai Yan Chiu, Rungsun Rerknimitr, Christopher Khor, Vu Van Khien, Kee Don Choi, Ki-Nam Shim, Geun Am Song, Oh Young Lee
    Clinical Endoscopy.2024; 57(2): 141.     CrossRef
  • Double-guidewire technique for selective biliary cannulation does not increase the rate of post-endoscopic retrograde cholangiopancreatography pancreatitis in patients with naïve papilla
    Han Taek Jeong, June Hwa Bae, Ho Gak Kim, Jimin Han
    Clinical Endoscopy.2024; 57(2): 226.     CrossRef
  • Computed tomography-based prediction of pancreatitis following biliary metal stent placement with the convolutional neural network
    Tsuyoshi Hamada, Koichiro Yasaka, Yousuke Nakai, Rintaro Fukuda, Ryunosuke Hakuta, Kazunaga Ishigaki, Sachiko Kanai, Kensaku Noguchi, Hiroki Oyama, Tomotaka Saito, Tatsuya Sato, Tatsunori Suzuki, Naminatsu Takahara, Hiroyuki Isayama, Osamu Abe, Mitsuhiro
    Endoscopy International Open.2024; 12(06): E772.     CrossRef
  • IDEN Consensus on Management of Antithrombotic Agents in Patients Undergoing Gastrointestinal Endoscopy
    Seung Joo Kang, Chung Hyun Tae, Chang Seok Bang, Cheol Min Shin, Young-Hoon Jeong, Miyoung Choi, Joo Ha Hwang, Yutaka Saito, Philip Wai Yan Chiu, Rungsun Rerknimitr, Christopher Khor, Vu Van Khien, Kee Don Choi, Ki-Nam Shim, Geun Am Song, Oh Young Lee
    The Korean Journal of Gastroenterology.2024; 83(6): 217.     CrossRef
  • International Digestive Endoscopy Network Consensus on the Management of Antithrombotic Agents in Patients Undergoing Gastrointestinal Endoscopy
    Seung Joo Kang, Chung Hyun Tae, Chang Seok Bang, Cheol Min Shin, Young-Hoon Jeong, Miyoung Choi, Joo Ha Hwang, Yutaka Saito, Philip Wai Yan Chiu, Rungsun Rerknimitr, Christopher Khor, Vu Van Khien, Kee Don Choi, Ki-Nam Shim, Geun Am Song, Oh Young Lee
    Gut and Liver.2024; 18(5): 764.     CrossRef
  • Risk factors for acute pancreatitis after endoscopic retrograde cholangiopancreatography: a retrospective single-center study
    I.М. Mamontov, D.D. Rjabushhenko, Т.І. Tamm, К.О. Kramarenko, V.V. Nepomniashchyi, A.T. Ustinov
    Український радіологічний та онкологічний журнал.2024; 32(3): 287.     CrossRef
  • Could assessment of genetic susceptibility be an effective solution to prevent pancreatitis from occurring after endoscopic retrograde cholangiopancreatography?
    Jae Min Lee
    The Korean Journal of Internal Medicine.2023; 38(6): 783.     CrossRef
  • 4,211 View
  • 368 Download
  • 8 Web of Science
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Case Report
Refractory benign biliary stricture due to chronic pancreatitis in two patients treated using endoscopic ultrasound-guided choledochoduodenostomy fistula creation: case reports
Sho Ishikawa, Nozomi Okuno, Kazuo Hara, Nobumasa Mizuno, Shin Haba, Takamichi Kuwahara, Yasuhiro Kuraishi, Takafumi Yanaidani
Clin Endosc 2024;57(1):122-127.   Published online May 16, 2023
DOI: https://doi.org/10.5946/ce.2022.149
AbstractAbstract PDFPubReaderePub
Benign biliary stricture (BBS) is a complication of chronic pancreatitis (CP). Despite endoscopic biliary stenting, some patients do not respond to treatment, and they experience recurrent cholangitis. We report two cases of CP with refractory BBS treated using endoscopic ultrasound-guided choledochoduodenostomy (EUS-CDS) fistula creation. A 50-year-old woman and a 60-year-old man both presented with obstructive jaundice secondary to BBS due to alcoholic CP. They underwent repeated placement of a fully covered self-expandable metal stent for biliary strictures. However, the strictures persisted, causing repeated episodes of cholangitis. Therefore, an EUS-CDS was performed. The stents were eventually removed and the patients became stent-free. These fistulas have remained patent without cholangitis for more than 2.5 years. Fistula creation using EUS-CDS is an effective treatment option for BBS.

Citations

Citations to this article as recorded by  
  • Forward viewing liner echoendoscopy for therapeutic interventions
    Kazuo Hara, Nozomi Okuno, Shin Haba, Takamichi Kuwahara
    Clinical Endoscopy.2024; 57(2): 175.     CrossRef
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Systematic Review and Meta-analysis
Safety of endoscopic retrograde cholangiopancreatography (ERCP) in cirrhosis compared to non-cirrhosis and effect of Child-Pugh score on post-ERCP complications: a systematic review and meta-analysis
Zahid Ijaz Tarar, Umer Farooq, Mustafa Gandhi, Saad Saleem, Ebubekir Daglilar
Clin Endosc 2023;56(5):578-589.   Published online May 2, 2023
DOI: https://doi.org/10.5946/ce.2023.027
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background
/Aims: The safety of endoscopic retrograde cholangiopancreatography (ERCP) in hepatic cirrhosis and the impact of Child-Pugh class on post-ERCP complications need to be better studied. We investigated the post-ERCP complication rates in patients with cirrhosis compared with those without cirrhosis.
Methods
We conducted a literature search of relevant databases to identify studies that reported post-ERCP complications in patients with hepatic cirrhosis.
Results
Twenty-four studies comprising 28,201 patients were included. The pooled incidence of post-ERCP complications in cirrhosis was 15.5% (95% confidence interval [CI], 11.8%–19.2%; I2=96.2%), with an individual pooled incidence of pancreatitis 5.1% (95% CI, 3.1%–7.2%; I2=91.5%), bleeding 3.6% (95% CI, 2.8%–4.5%; I2=67.5%), cholangitis 2.9% (95% CI, 1.9%–3.8%; I2=83.4%), and perforation 0.3% (95% CI, 0.1%–0.5%; I2=3.7%). Patients with cirrhosis had a greater risk of post-ERCP complications (risk ratio [RR], 1.41; 95% CI, 1.16–1.71; I2=56.3%). The risk of individual odds of adverse events between cirrhosis and non-cirrhosis was as follows: pancreatitis (RR, 1.25; 95% CI, 1.06–1.48; I2=24.8%), bleeding (RR, 1.94; 95% CI, 1.59–2.37; I2=0%), cholangitis (RR, 1.15; 95% CI, 0.77–1.70; I2=12%), and perforation (RR, 1.20; 95% CI, 0.59–2.43; I2=0%).
Conclusions
Cirrhosis is associated with an increased risk of post-ERCP pancreatitis, bleeding, and cholangitis.

Citations

Citations to this article as recorded by  
  • The Impact of Frailty on ERCP-Related Adverse Events: Findings From a National Cohort
    Umer Farooq, Zahid Ijaz Tarar, Abdallah El Alayli, Faisal Kamal, Alexander Schlachterman, Anand Kumar, David E. Loren, Thomas E. Kowalski
    Techniques and Innovations in Gastrointestinal Endoscopy.2024; 26(2): 138.     CrossRef
  • Applicability of Child-Turcotte-Pugh Score in Anticipating Post-ERCP Adverse Events in Patients With Cirrhosis
    Saqr Alsakarneh, Fouad Jaber, Willie Mohammed, Mohammad Almeqdadi, Abdallah Al-Ani, Yassine Kilani, Saeed Abughazaleh, Laith Momani, Muhammad Shah Miran, Hassan Ghoz, John Helzberg, Wendell Clarkston, Mohamed Othman
    Journal of Clinical Gastroenterology.2024;[Epub]     CrossRef
  • Quality Indicators of Endoscopic Retrograde Cholangiopancreatography in Korea
    Hyung Ku Chon, Ki-Hyun Kim, Tae Jun Song, Dong-Won Ahn, Eaum Seok Lee, Yun Nah Lee, Yoon Suk Lee, Tae Joo Jeon, Chang Hwan Park, Kwang Bum Cho, Dong Wook Lee, Jin-Seok Park, Seung Bae Yoon, Kwang Hyun Chung, Jin Lee, Miyoung Choi
    Gut and Liver.2024; 18(4): 564.     CrossRef
  • Quality Indicators of Endoscopic Retrograde Cholangiopancreatography in Korea
    Ki-Hyun Kim, Hyung Ku Chon, Tae Jun Song, Dong Won Ahn, Eaum Seok Lee, Yun Nah Lee, Yoon Suk Lee, Tae Joo Jeon, Chang Hwan Park, Kwang Bum Cho, Dong Wook Lee, Jin-Seok Park, Seung Bae Yoon, Kwang Hyung Chung, Jin Lee, Miyoung Choi
    The Korean Journal of Gastroenterology.2024; 84(3): 111.     CrossRef
  • ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY FOR THE MANAGEMENT OF CHOLEDOCHOLITHIASIS IN OLDER PATIENTS
    Júlia Gardenyes, Pere Roura, Helena Vallverdú-Cartie, Judit Hermoso-Bosch, Cl�udia Roca, Mariona Espaulella, Antoni Casals, Héctor Ivo Marani, Joan Saló, Martín Galdín, Marta Gallach, Carles Leal
    Revista Española de Enfermedades Digestivas.2023;[Epub]     CrossRef
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Original Articles
Safety and feasibility of opening window fistulotomy as a new precutting technique for primary biliary access in endoscopic retrograde cholangiopancreatography
Yasuhiro Kuraishi, Kazuo Hara, Shin Haba, Takamichi Kuwahara, Nozomi Okuno, Takafumi Yanaidani, Sho Ishikawa, Tsukasa Yasuda, Masanori Yamada, Nobumasa Mizuno
Clin Endosc 2023;56(4):490-498.   Published online April 27, 2023
DOI: https://doi.org/10.5946/ce.2022.130
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background
/Aims: Post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP) is the most common and serious complication of endoscopic retrograde cholangiopancreatography. To prevent this event, a unique precutting method, termed opening window fistulotomy, was performed in patients with a large infundibulum as the primary procedure for biliary cannulation, whereby a suprapapillary laid-down H-shaped incision was made without touching the orifice. This study aimed to assess the safety and feasibility of this novel technique.
Methods
One hundred and ten patients were prospectively enrolled in this study. Patients with a papillary roof size ≥10 mm underwent opening window fistulotomy for primary biliary access. In addition, the incidence of complications and success rate of biliary cannulation were evaluated.
Results
The median size of the papillary roof was 6 mm (range, 3–20 mm). Opening window fistulotomy was performed in 30 patients (27.3%), none of whom displayed PEP. Duodenal perforation was recorded in one patient (3.3%), which was resolved by conservative treatment. The cannulation rate was high (96.7%, 29/30 patients). The median duration of biliary access was 8 minutes (range, 3–15 minutes).
Conclusions
Opening window fistulotomy demonstrated its feasibility for primary biliary access by achieving great safety with no PEP complications and a high success rate for biliary cannulation.

Citations

Citations to this article as recorded by  
  • Comments on ‘Safety and feasibility of opening window fistulotomy as a new precutting technique for primary biliary access in endoscopic retrograde cholangiopancreatography’
    Masood Muhammad Karim, Adeel Ur Rehman, Faisal Wasim Ismail, Om Parkash
    Clinical Endoscopy.2024; 57(2): 280.     CrossRef
  • 3,215 View
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Diagnostic value of homogenous delayed enhancement in contrast-enhanced computed tomography images and endoscopic ultrasound-guided tissue acquisition for patients with focal autoimmune pancreatitis
Keisuke Yonamine, Shinsuke Koshita, Yoshihide Kanno, Takahisa Ogawa, Hiroaki Kusunose, Toshitaka Sakai, Kazuaki Miyamoto, Fumisato Kozakai, Hideyuki Anan, Haruka Okano, Masaya Oikawa, Takashi Tsuchiya, Takashi Sawai, Yutaka Noda, Kei Ito
Clin Endosc 2023;56(4):510-520.   Published online April 5, 2023
DOI: https://doi.org/10.5946/ce.2022.142
Graphical AbstractGraphical Abstract AbstractAbstract PDFPubReaderePub
Background
/Aims: We aimed to investigate (1) promising clinical findings for the recognition of focal type autoimmune pancreatitis (FAIP) and (2) the impact of endoscopic ultrasound (EUS)-guided tissue acquisition (EUS-TA) on the diagnosis of FAIP.
Methods
Twenty-three patients with FAIP were involved in this study, and 44 patients with resected pancreatic ductal adenocarcinoma (PDAC) were included in the control group.
Results
(1) Multivariate analysis revealed that homogeneous delayed enhancement on contrast-enhanced computed tomography was a significant factor indicative of FAIP compared to PDAC (90% vs. 7%, p=0.015). (2) For 13 of 17 FAIP patients (76.5%) who underwent EUS-TA, EUS-TA aided the diagnostic confirmation of AIPs, and only one patient (5.9%) was found to have AIP after surgery. On the other hand, of the six patients who did not undergo EUS-TA, three (50.0%) underwent surgery for pancreatic lesions.
Conclusions
Homogeneous delayed enhancement on contrast-enhanced computed tomography was the most useful clinical factor for discriminating FAIPs from PDACs. EUS-TA is mandatory for diagnostic confirmation of FAIP lesions and can contribute to a reduction in the rate of unnecessary surgery for patients with FAIP.

Citations

Citations to this article as recorded by  
  • A multidisciplinary approach is essential for differentiating autoimmune pancreatitis from pancreatic adenocarcinoma
    Sung-Hoon Moon
    Clinical Endoscopy.2023; 56(4): 457.     CrossRef
  • 2,217 View
  • 84 Download
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Role of vitamin C and rectal indomethacin in preventing and alleviating post-endoscopic retrograde cholangiopancreatography pancreatitis: a clinical study
Amir Sadeghi, Rana Jafari-Moghaddam, Sara Ataei, Mahboobe Asadiafrooz, Mohammad Abbasinazari
Clin Endosc 2023;56(2):214-220.   Published online March 6, 2023
DOI: https://doi.org/10.5946/ce.2022.165
Graphical AbstractGraphical Abstract AbstractAbstract PDFPubReaderePub
Background
/Aims: This study aimed to determine whether vitamin C in addition to indomethacin decreases the occurrence and severity of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) occurrence and severity.
Methods
This randomized clinical trial included patients undergoing ERCP. The participants were administered either rectal indomethacin (100 mg) plus an injection of vitamin C (500 mg) or rectal indomethacin (100 mg) alone just before ERCP. The primary outcomes were PEP occurrence and severity. The secondary amylase and lipase levels were determined after 24 hours.
Results
A total of 344 patients completed the study. Based on intention-to-treat analysis, the PEP rates were 9.9% for indomethacin plus vitamin C plus indomethacin and 15.7% for indomethacin alone. Regarding the per-protocol analysis, the PEP rates were 9.7% and 15.7% in the combination and indomethacin arms, respectively. There was a remarkable difference between the two arms in PEP occurrence and severity on intention-to-treat and per-protocol analyses (p=0.034 and p=0.031, respectively). The post-ERCP lipase and amylase concentrations were lower in the combination arm than in the indomethacin alone arm (p=0.034 and p=0.029, respectively).
Conclusions
Vitamin C injection in addition to rectal indomethacin reduced PEP occurrence and severity.

Citations

Citations to this article as recorded by  
  • Effect of CoQ10 Addition to Rectal Indomethacin on Clinical Pancreatitis and Related Biomarkers in Post-endoscopic Retrograde Cholangiopancreatography
    Saeed Abdi, Roja Qobadighadikolaei, Faezeh Jamali, Maryam Shahrokhi, Farzaneh Dastan, Mohammad Abbasinazari
    Journal of Cellular & Molecular Anesthesia.2024;[Epub]     CrossRef
  • Double-guidewire technique for selective biliary cannulation does not increase the rate of post-endoscopic retrograde cholangiopancreatography pancreatitis in patients with naïve papilla
    Han Taek Jeong, June Hwa Bae, Ho Gak Kim, Jimin Han
    Clinical Endoscopy.2024; 57(2): 226.     CrossRef
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  • 168 Download
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Preventive effect of tacrolimus on patients with post-endoscopic retrograde cholangiopancreatography pancreatitis
Harshavardhan Rao B., Paul K. Vincent, Priya Nair, Anoop K. Koshy, Rama P. Venu
Clin Endosc 2022;55(5):665-673.   Published online August 2, 2022
DOI: https://doi.org/10.5946/ce.2021.265
AbstractAbstract PDFPubReaderePub
Background
/Aims: In patients undergoing endoscopic retrograde cholangiopancreatography (ERCP), calcineurin activates zymogen, which results in pancreatitis. In this study, we aimed to determine the efficacy of tacrolimus, a calcineurin inhibitor, in preventing post-ERCP pancreatitis (PEP).
Methods
This was a prospective pilot study in which patients who underwent ERCP received tacrolimus (4 mg in two divided doses); this was the Tac group. A contemporaneous cohort of patients was included as a control group. All patients were followed-up for PEP. PEP was characterized by worsening abdominal pain with an acute onset, elevated pancreatic enzymes, and a duration of hospital stay of more than 48 hours. Serum tacrolimus levels were measured immediately before the procedure in the Tac group.
Results
There were no differences in the baseline characteristics between the Tac group (n=48) and the control group (n=51). Only four out of 48 patients (8.3%) had PEP in the Tac group compared to eight out of 51 patients (15.7%) who had PEP in the control group. The mean trough tacrolimus level in patients who developed PEP was significantly lower (p<0.05).
Conclusions
Oral tacrolimus at a cumulative dose of 4 mg safely prevents PEP. Further randomized controlled studies are warranted to establish the role of tacrolimus in this context.

Citations

Citations to this article as recorded by  
  • Acute pancreatitis: pathogenesis and emerging therapies
    Saif Zaman, Fred Gorelick
    Journal of Pancreatology.2024; 7(1): 10.     CrossRef
  • Preclinical safety evaluation of calcineurin inhibitors delivered through an intraductal route to prevent post-ERCP pancreatitis demonstrates endocrine and systemic safety
    Jianbo Ni, Asna Khalid, Yu-Chu Lin, Monique T. Barakat, Jing Wang, Cheng-Yu Tsai, Pasha Reza Shams Azar, Ying Ding, Judy-April Murayi, Thottala Jayaraman, Ronald Poropatich, Rita Bottino, Li Wen, Georgios I. Papachristou, Gayathri Swaminathan, Mang Yu, So
    Pancreatology.2023; 23(4): 333.     CrossRef
  • Could assessment of genetic susceptibility be an effective solution to prevent pancreatitis from occurring after endoscopic retrograde cholangiopancreatography?
    Jae Min Lee
    The Korean Journal of Internal Medicine.2023; 38(6): 783.     CrossRef
  • Rectal administration of tacrolimus protects against post-ERCP pancreatitis in mice
    Yu-Chu Lin, Jianbo Ni, Gayathri Swaminathan, Asna Khalid, Monique T. Barakat, Adam R. Frymoyer, Cheng-Yu Tsai, Ying Ding, Judy-April Murayi, Thottala Jayaraman, Ronald Poropatich, Rita Bottino, Li Wen, Georgios I. Papachristou, Sunil G. Sheth, Mang Yu, So
    Pancreatology.2023; 23(7): 777.     CrossRef
  • Tacrolimus for prophylaxis of post-endoscopic retrograde cholangiopancreatography pancreatitis: a potential new target of old drug?
    Seok Jeong
    Clinical Endoscopy.2022; 55(5): 628.     CrossRef
  • 3,036 View
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Review
Clinical Practice Guidelines for the Endoscopic Management of Peripancreatic Fluid Collections
Chi Hyuk Oh, Jun Kyu Lee, Tae Jun Song, Jin-Seok Park, Jae Min Lee, Jun Hyuk Son, Dong Kee Jang, Miyoung Choi, Jeong-Sik Byeon, In Seok Lee, Soo Teik Lee, Ho Soon Choi, Ho Gak Kim, Hoon Jai Chun, Chan Guk Park, Joo Young Cho
Clin Endosc 2021;54(4):505-521.   Published online July 27, 2021
DOI: https://doi.org/10.5946/ce.2021.185
AbstractAbstract PDFPubReaderePub
Endoscopic ultrasonography-guided intervention has gradually become a standard treatment for peripancreatic fluid collections (PFCs). However, it is difficult to popularize the procedure in Korea because of restrictions on insurance claims regarding the use of endoscopic accessories, as well as the lack of standardized Korean clinical practice guidelines. The Korean Society of Gastrointestinal Endoscopy (KSGE) appointed a Task Force to develope medical guidelines by referring to the manual for clinical practice guidelines development prepared by the National Evidence-Based Healthcare Collaborating Agency. Previous studies on PFCs were searched, and certain studies were selected with the help of experts. Then, a set of key questions was selected, and treatment guidelines were systematically reviewed. Answers to these questions and recommendations were selected via peer review. This guideline discusses endoscopic management of PFCs and makes recommendations on Indications for the procedure, pre-procedural preparations, optimal approach for drainage, procedural considerations (e.g., types of stent, advantages and disadvantages of plastic and metal stents, and accessories), adverse events of endoscopic intervention, and procedural quality issues. This guideline was reviewed by external experts and suggests best practices recommended based on the evidence available at the time of preparation. This will be revised as necessary to address advances and changes in technology and evidence obtained in clinical practice and future studies.

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  • Pancreatic Pseudocyst after Fully Covered Self-expandable Metallic Stent Placement: A Case Report
    Mitsuhito Koizumi, Sho Ishikawa, Kaori Marui, Masahito Kokubu, Yusuke Okujima, Yuki Numata, Yoshiki Imamura, Teru Kumagi, Yoichi Hiasa
    Internal Medicine.2024;[Epub]     CrossRef
  • Neutrophil Gelatinase-Associated Lipocalin for the Differentiation of Mucinous Pancreatic Cystic Lesions
    Miruna Patricia Olar, Maria Iacobescu, Sorana D. Bolboacă, Cristina Pojoga, Ofelia Moșteanu, Radu Seicean, Ioana Rusu, Oana Banc, Cristina Adela Iuga, Andrada Seicean
    International Journal of Molecular Sciences.2024; 25(6): 3224.     CrossRef
  • Comparative outcome of single versus two double-pigtail stents for endoscopic drainage of pancreatic fluid collections with minimal necrosis: a retrospective analysis
    S Giri, S Bhrugumalla, S Gangadhar, S Angadi
    Acta Gastro Enterologica Belgica.2024; 87(1): 1.     CrossRef
  • Use of an endoscopic powered debridement device for treatment of post-surgical fatty pancreatic necrosis
    Judy Daboul, Shiab Mussad, Anna Cecilia Amaral, Waleed K. Hussain, Peter J. Lee, Samuel Han
    Clinical Endoscopy.2024; 57(3): 412.     CrossRef
  • Single double pigtail plastic stent (DPT) is equally effective to two double pigtail plastic stent for endoscopic ultrasonography-guided drainage of "symptomatic peripancreatic fluid collection with 30 % or less necrotic debris"
    Hemanta Kumar Nayak, Shubham Gupta, Manas Kumar Panigrahi, Abhijeet Rai, Saswati Kar, Mansi Chaudhary, Ajay Ghosh, Taraprasad Tripathy, Bramhadatta Pattnaik, Subash Chandra Samal
    Pancreatology.2024;[Epub]     CrossRef
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    Dong Kee Jang, Dong Wook Lee, Seong-Hun Kim, Kwang Bum Cho, Sundeep Lakhtakia
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  • Endoscopic ultrasound-guided drainage for local complications related to pancreatitis
    Hyung Ku Chon, Seong-Hun Kim
    International Journal of Gastrointestinal Intervention.2023; 12(1): 7.     CrossRef
  • A preferable modality for the differentiation of peripancreatic fluid collections: Endoscopic ultrasound
    Ning Xu, Longsong Li, Danqi Zhao, Zixin Wang, Xueting Wang, Runzi Wang, Yanbo Zeng, Lei Zhang, Ning Zhong, Ying Lv, Enqiang Linghu, Ningli Chai
    Endoscopic Ultrasound.2022; 11(4): 291.     CrossRef
  • Disconnected pancreatic duct syndrome in acute pancreatitis
    A.V. Fedorov, V.N. Ektov, M.A. Khodorkovsky
    Khirurgiya. Zhurnal im. N.I. Pirogova.2022; (8): 83.     CrossRef
  • Single balloon enteroscopy-guided endoscopic retrograde pancreatography for the treatment of a symptomatic pancreatic pseudocyst complicated by pancreaticojejunostomy stricture: A case report
    Eunae Cho, Chang-Hwan Park, Seo Yeon Cho
    Medicine.2022; 101(43): e31293.     CrossRef
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Case Report
Gastroduodenal intussusception of a gastrointestinal stromal tumor: a rare cause of acute pancreatitis
Pornpayom Numpraphrut, Sorachat Niltwat, Thammawat Parakonthun, Nonthalee Pausawasdi
Clin Endosc 2022;55(3):447-451.   Published online June 22, 2021
DOI: https://doi.org/10.5946/ce.2021.073
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Patients with symptomatic gastrointestinal stromal tumor (GIST) typically present with gastrointestinal bleeding and abdominal pain. This report presents an unusual case of fundic GIST complicated by gastroduodenal intussusception, manifesting as acute pancreatitis. The patient presented with epigastric pain and pancreatic enzyme elevation; thus, he was diagnosed with acute pancreatitis. Computed tomography showed evidence of pancreatitis and a 4×4.7 cm well-defined hyperdense lesion in the 2nd part of the duodenum, compressing the pancreatic head and pancreatic duct. Esophagogastroduodenoscopy revealed invagination of the gastric folds into the duodenum, causing pyloric canal blockage consistent with gastroduodenal intussusception. Spontaneous reduction of the lesion during endoscopy revealed a 4 cm pedunculated subepithelial mass with central ulceration originating from the gastric fundus. Endoscopic ultrasound demonstrated a heterogeneous hypoechoic lesion originating from the 4th layer of the gastric wall. Laparoscopic-endoscopic intragastric wedge resection of the fundic lesion was subsequently performed, and surgical histology confirmed GIST.

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  • Gastroduodenal intussusception caused by gastric gastrointestinal stromal tumor in adults: a case report and literature review
    Wenbing Zhang, Haifeng Chen, Lulu Zhu, Zhiyuan Kong, Tingting Wang, Weiping Li
    Journal of International Medical Research.2022;[Epub]     CrossRef
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  • 2 Web of Science
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Original Articles
Endoscopic Interventions for the Early and Remission Phases of Acute Biliary Pancreatitis: What are the More Concrete and Practical Situations for Performing Them?
Sho Hasegawa, Shinsuke Koshita, Yoshihide Kanno, Takahisa Ogawa, Toshitaka Sakai, Hiroaki Kusunose, Kensuke Kubota, Atsushi Nakajima, Yutaka Noda, Kei Ito
Clin Endosc 2021;54(6):888-898.   Published online May 27, 2021
DOI: https://doi.org/10.5946/ce.2020.271
AbstractAbstract PDFPubReaderePub
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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Outcomes of Dilation of Recalcitrant Pancreatic Strictures Using a Wire-Guided Cystotome
Sridhar Sundaram, Dhaval Choksi, Aditya Kale, Suprabhat Giri, Biswaranjan Patra, Shobna Bhatia, Akash Shukla
Clin Endosc 2021;54(6):903-908.   Published online March 4, 2021
DOI: https://doi.org/10.5946/ce.2020.297
AbstractAbstract PDFPubReaderePub
Background
/Aims: Pancreatic strictures in chronic pancreatitis are treated using endoscopic retrograde cholangiopancreatography (ERCP) with plastic stent placement. The management of recalcitrant strictures remains a challenge, with the use of a Soehendra stent retriever or a needle knife described in case reports. Here, we discuss our experience with dilation of dominant pancreatic strictures with a 6-Fr cystotome.
Methods
A retrospective review of an endoscopy database was performed to search for patients with pancreatic strictures recalcitrant to conventional methods of dilation in which a cystotome was used. Technical success was defined as the successful dilation of the stricture with plastic stent placement. Functional success was defined as substantial pain relief or resolution of pancreatic fistulae.
Results
Ten patients (mean age, 30.8 years) underwent dilation of a dominant pancreatic stricture secondary to chronic pancreatitis, with a 6-Fr cystotome. Seven patients presented with pain. Three patients had pancreatic fistulae (two had pancreatic ascites and one had a pancreaticopleural fistula). The median stricture length was 10 mm (range, 5–25 mm). The head of the pancreas was the most common location of the stricture (60%). Technical and functional success was achieved in all patients. One patient had self-limiting bleeding, whereas another patient developed mild post-ERCP pancreatitis.
Conclusions
The use of a 6-Fr cystotome (diathermy catheter) can be an alternative method for dilation of recalcitrant pancreatic strictures after the failure of conventional modalities.

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  • Fully Covered Self-expandable Metallic Stents for Refractory Benign Pancreatic Duct Strictures: A Systematic Review and Meta-analysis
    Gajanan Rodge, Suprabhat Giri, Kailash Kolhe, Shivaraj Afzalpurkar, Sidharth Harindranath, Sridhar Sundaram, Aditya Kale
    Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.2024; 34(5): 529.     CrossRef
  • Treatment of Difficult Pancreatic Duct Strictures Using a Cystotome: A Single-Center Experience
    Jonghyun Lee, Dong Uk Kim, Sung Yong Han
    The Korean Journal of Pancreas and Biliary Tract.2023; 28(4): 108.     CrossRef
  • Approach to management of pancreatic strictures: the gastroenterologist’s perspective
    Vaneet Jearth, Suprabhat Giri, Sridhar Sundaram
    Clinical Journal of Gastroenterology.2021; 14(6): 1587.     CrossRef
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RWON Study: The Real-World Walled-off Necrosis Study
Ankush Pawar, Ujjwal Sonika, Manish Kumar, Sundeep Saluja, Siddharth Srivastava
Clin Endosc 2021;54(6):909-915.   Published online February 23, 2021
DOI: https://doi.org/10.5946/ce.2020.175
AbstractAbstract PDFPubReaderePub
Background
/Aims: The management of walled-off necrosis (WON) has undergone a paradigm shift from surgical to nonsurgical modalities. Real-world data on the management of symptomatic WON are scarce.
Methods
Prospectively collected data of symptomatic WON cases were retrospectively evaluated. The treatment modalities used were medical management alone, percutaneous catheter drainage (PCD) or endoscopic drainage (ED), or a combination of PCD and ED. We compared clinical outcome among these modalities.
Results
A total of 264 patients were evaluated. The most common indications for drainage were pain and fever. Of the patients, 28% was treated with medical therapy alone, 31% with ED, 37% with PCD, and 4% with a combined approach. Technical success and clinical success were achieved in 93% and 91% of patients in the endoscopic arm and in 90% and 81% patients in the PCD arm, respectively (p=0.0004 for clinical success). Lower rates of complications (7% vs. 22%, p=0.005), readmission (20% vs. 34%, p=0.04), and mortality (4% vs. 19%, p=0.0012), and shorter hospital stay (13 days vs. 19 days, p=0.0018) were observed in the endoscopic group than in the PCD group.
Conclusions
ED of WON is better than PCD and is associated with lower mortality, fewer complications, and shorter hospitalization.

Citations

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  • Endoscopic ultrasound drainage of pancreatic fluid collections: do we know enough about the best approach?
    Andrada Seicean, Cristina Pojoga, Voicu Rednic, Claudia Hagiu, Radu Seicean
    Therapeutic Advances in Gastroenterology.2023;[Epub]     CrossRef
  • Treatment of Walled-off Necrosis – Outcomes are Best When Endoscopy and Percutaneous Interventions are Complimentary, Not Exclusive
    Ji Young Bang, Shyam Varadarajulu
    Clinical Endoscopy.2021; 54(6): 785.     CrossRef
  • 4,210 View
  • 147 Download
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Increased Risk of Pancreatitis after Endoscopic Retrograde Cholangiopancreatography Following a Positive Intraoperative Cholangiogram: A Single-Center Experience
Lalitha M. Sitaraman, Rita M. Knotts, Judith Kim, Srihari Mahadev, David S. Lee
Clin Endosc 2021;54(1):107-112.   Published online July 15, 2020
DOI: https://doi.org/10.5946/ce.2020.025
AbstractAbstract PDFPubReaderePub
Background
/Aims: To determine if patients with a positive intraoperative cholangiogram (IOC) who undergo a subsequent endoscopic retrograde cholangiopancreatography (ERCP) have an increased risk of post-ERCP pancreatitis (PEP) compared to those who undergo ERCP directly for suspected common bile duct stones.
Methods
A retrospective case-control study was performed from 2010 to 2016. Cases included inpatients with a positive IOC at cholecystectomy who underwent subsequent ERCP. The control group included age-sex matched cohorts who underwent ERCP for choledocholithiasis. Multivariate logistic regression was used to assess the association between PEP and positive IOC, adjusting for matching variables and additional potential confounders.
Results
Of the 116 patients that met the inclusion criteria, there were 91 women (78%) in each group. Nine patients (7.8%) developed PEP in the IOC group, compared to 3 patients in the control group (2.6%). The use of pancreatic duct stents and rectal indomethacin was similar in both groups. After adjusting for age, sex, total bilirubin levels, and any stent placement, patients with a positive IOC had a significantly increased risk of PEP (odds ratio, 4.79; 95% confidence interval, 1.05–21.89; p<0.05).
Conclusions
In this single-center case-control study, there was a five-fold increased risk of PEP following a positive IOC compared to an age-sex matched cohort.

Citations

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  • Is Routine Intraoperative Cholangiogram Necessary in Patients With Mild Acute Biliary Pancreatitis Undergoing Index Admission Cholecystectomy?
    Natalie M Quarmby, Minh Tu Vo, Sivakumar Gananadha
    The American Surgeon™.2024;[Epub]     CrossRef
  • Accuracy of intraoperative cholangiography and outcomes of ERCP in hospitalized patients with suspected choledocholithiasis
    Masuma Syed, Sanghee K. Choi, Nikhil Thiruvengadam, Kendrick Che, Paul Leonor, Esther Wu, Maryam B. Tabrizi, Jeffrey Kim, Stephen Min, James Scheiman, John J. Kim
    iGIE.2023; 2(2): 117.     CrossRef
  • Endoscopic retrograde cholangiopancreatography is not necessary in all patients with an abnormal intraoperative cholangiogram
    Andrawus Beany, Anandpreet S Ghataura, Shaanan T E Yong, Kee F Loo, Rajvinder Singh, Biju George, Mohamed A Chinnaratha
    JGH Open.2023; 7(11): 797.     CrossRef
  • Endoscopic retrograde cholangiopancreatography‐related adverse events in Korea: A nationwide assessment
    Dong Kee Jang, Jungmee Kim, Chang Nyol Paik, Jung‐Wook Kim, Tae Hee Lee, Jae‐Young Jang, Seung Bae Yoon, Jun Kyu Lee
    United European Gastroenterology Journal.2022; 10(1): 73.     CrossRef
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  • 3 Web of Science
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Case Report
Acute Pancreatitis: A Rare Post-Colonoscopy Sequela
Sujit P. Nair, Prasanta Debnath, Suhas Udgirkar, Parmeshwar Junare, Sanjay Chandnani, Shubham Jain, Vinay B. Pawar, Pravin M. Rathi
Clin Endosc 2020;53(5):611-614.   Published online February 12, 2020
DOI: https://doi.org/10.5946/ce.2019.151
AbstractAbstract PDFPubReaderePub
Abdominal pain is a common but benign symptom after colonoscopy. We report a case of acute pancreatitis that occurred just after an elective screening colonoscopy; this is a rare event with very few reported cases. A healthy, asymptomatic male underwent screening colonoscopy at our center and developed abdominal pain and emesis after the procedure. An abdominal X-ray ruled out perforation but laboratory tests revealed elevated levels of amylase and lipase. The patient had no etiological risk factors for pancreatitis. The presumed mechanism of pancreatitis in this case is mechanical and pressure trauma from excessive insufflation, external abdominal pressure, and repeated withdrawal of the colonoscope due to tight angulation of the splenic flexure, a structure that is in close proximity to the pancreatic tail. Acute pancreatitis should be considered in the differential diagnosis of patients who present with abdominal pain after colonoscopy once more common etiologies have been excluded.

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  • Aggravated pancreatitis after performing a colonoscopy
    Han‐Lin Liao, Tyng‐Yuan Jang
    Advances in Digestive Medicine.2024;[Epub]     CrossRef
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    Saima H Shawl, Usama Bilal, Chandra Essar Mal, Veera Durga Vaishnavi Kurra, Romil Singh
    Cureus.2022;[Epub]     CrossRef
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    Abhishek Keraliya, Hei Shun Yu, Jennifer W. Uyeda
    Emergency Radiology.2022; 29(5): 915.     CrossRef
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  • 109 Download
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Original Article
Endoscopic Therapy for Pancreatic Fluid Collections: A Definitive Management Using a Dedicated Algorithm
Ming Ming Xu, Iman Andalib, Aleksey Novikov, Enad Dawod, Moamen Gabr, Monica Gaidhane, Amy Tyberg, Michel Kahaleh
Clin Endosc 2020;53(3):355-360.   Published online December 3, 2019
DOI: https://doi.org/10.5946/ce.2019.113
AbstractAbstract PDFPubReaderePub
Background
/Aims: Endoscopic ultrasonography (EUS)-guided drainage is the preferred approach for infected or symptomatic pancreatic fluid collections (PFCs). Here, we developed an algorithm for the management of pancreatitis complicated by PFCs and report on its effcacy and safety.
Methods
Between September 2011 and October 2017, patients were prospectively managed according to the algorithm. PFCs were classified as poorly organized fluid collections (POFCs), pancreatic pseudocysts (PPs), or walled-off pancreatic necrosis (WOPN). Clinical success was defined as a decrease in PFC size by ≥50% of the maximal diameter or to ≤2 cm.
Results
 A total of 108 patients (62% male; mean age, 53 years) were included: 13 had POFCs, 43 had PPs, and 52 had WOPN. Seventytwo patients (66%) required a pancreatic duct (PD) stent, whereas 65 (60%) received enteral feeding. A total of 103 (95%) patients achieved clinical success. Eight patients experienced complications including bleeding (n=6) and surgical intervention (n=2). Patients with enteral feeding were 3.4 times more likely to achieve resolution within 60 days (p=0.0421), whereas those with PD stenting was five times more likely to achieve resolution within 90 days (p=0.0069).
Conclusions
 A high PFC resolution rate can be achieved when a dedicated algorithm encompassing EUS-guided drainage, PD stenting, and early enteral feeding is adopted.

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    Serge Baroud, Vinay Chandrasekhara, Andrew C. Storm, Ryan J. Law, Eric J. Vargas, Michael J. Levy, Tala Mahmoud, Fateh Bazerbachi, Aliana Bofill-Garcia, Rabih Ghazi, Daniel B. Maselli, John A. Martin, Santhi Swaroop Vege, Naoki Takahashi, Bret T. Petersen
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    Liang Chen, Ting Li, Bin Wang, Yunxiao Cheng, Sicong Zhao, Yunxiao Lyu
    Asian Journal of Surgery.2022; 45(8): 1519.     CrossRef
  • Transluminal and retroperitoneal minimally invasive necrosectomy in acute pancreatitis
    A. V. Fedorov, V. N. Ektov, M. A. Khodorkovskiy
    Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery.2022; 27(3): 81.     CrossRef
  • Endoscopic transluminal interventions in the treatment of acute necrotizing pancreatitis
    A.V. Fedorov, V.N. Ektov, M.A. Khodorkovsky
    Khirurgiya. Zhurnal im. N.I. Pirogova.2021; (9): 85.     CrossRef
  • Hydrogen peroxide assisted endoscopic necrosectomy for walled-off pancreatic necrosis: A systematic review and meta-analysis
    Rajat Garg, Shradha Gupta, Amandeep Singh, Marian T. Simonson, Tarun Rustagi, Prabhleen Chahal
    Pancreatology.2021; 21(8): 1540.     CrossRef
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    Robert Dorrell, Swati Pawa, Yi Zhou, Neeraj Lalwani, Rishi Pawa
    Diagnostics.2020; 10(5): 337.     CrossRef
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    Seong-Hun Kim, Eun Ji Shin
    Clinical Endoscopy.2020; 53(3): 253.     CrossRef
  • Role of pancreatography in the endoscopic management of encapsulated pancreatic collections – review and new proposed classification
    Igor Mendonça Proença, Marcos Eduardo Lera dos Santos, Diogo Turiani Hourneaux de Moura, Igor Braga Ribeiro, Sergio Eiji Matuguma, Spencer Cheng, Thomas R McCarty, Epifanio Silvino do Monte Junior, Paulo Sakai, Eduardo Guimarães Hourneaux de Moura
    World Journal of Gastroenterology.2020; 26(45): 7104.     CrossRef
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Review
Atraumatic Splenic Hemorrhage as a Rare Complication of Pancreatitis: Case Report and Literature Review
Deepanshu Jain, Byeori Lee, Michael Rajala
Clin Endosc 2020;53(3):311-320.   Published online July 24, 2019
DOI: https://doi.org/10.5946/ce.2019.087
AbstractAbstract PDFPubReaderePub
Splenic hemorrhage (hematoma and rupture) is a rare complication of pancreatitis. In this article, we present a rare case of spontaneous splenic rupture as a complication of acute pancreatitis. A literature review was also completed to describe the patient characteristics, associated pancreatitis etiology, clinical presentations, risk factors, diagnostic and treatment modalities, and outcomes.

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  • Akute nekrotisierende Pankreatitis mit hämorrhagischem Schock bei sekundärer Milzruptur: Ein Fallbericht und Literaturübersicht
    Leon Kaiser, Golo Petzold, Ali Seif Amir Hosseini, Volker Ellenrieder, Albrecht Neesse, Christoph Ammer-Herrmenau
    Zeitschrift für Gastroenterologie.2023; 61(11): 1494.     CrossRef
  • Association of Atraumatic Splenic Rupture and Acute Pancreatitis: Case Report with Literature Review
    Lidija Ljubicic, Vibor Sesa, Silvija Cukovic-Cavka, Ivan Romic, Igor Petrovic, Neil Donald Merrett
    Case Reports in Surgery.2022; 2022: 1.     CrossRef
  • Acute pancreatitis with necrosis of the transverse colon and the great gastric curvature
    Pietro CUMBO, Gabriella CAVALOT, Annalisa ROMANO, Marco ALLASIA, Carlo PALENZONA, Francesco POTENTE, Mariangela AZZELLINO, Luca B. LO PICCOLO
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    Madani Ayoub, Mohamed Yassine Mabrouk, Hajar Abdelouahab, Imane Kamaoui, Miry Achraf, Siham Hamaz, Khalid Serraj, Jabi Rachid, Bouziane Mohamed
    International Journal of Surgery Case Reports.2022; 96: 107315.     CrossRef
  • Complications of chronic pancreatitis prior to and following surgical treatment: A proposal for classification
    Marko Murruste, Ülle Kirsimägi, Karri Kase, Tatjana Veršinina, Peep Talving, Urmas Lepner
    World Journal of Clinical Cases.2022; 10(22): 7808.     CrossRef
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    Héloïse Tessely, Stéphane Journe, Raphaël Katz, Jean Lemaitre
    International Journal of Surgery Case Reports.2021; 80: 105607.     CrossRef
  • Atraumatic splenic rupture in patient with acute pancreatitis
    Roshini Nadaraja, Zarif Yahya, Krinal Mori, Ahmad Aly
    BMJ Case Reports.2021; 14(3): e238559.     CrossRef
  • Splenic injury following endoscopic drainage of a large pancreatic pseudocyst: a case report
    Krittin J. Supapannachart, Christopher R. Funk, Lauren M. Gensler, Matthew P. Butters
    Journal of Medical Case Reports.2021;[Epub]     CrossRef
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    Rita Martelo, João C Morais, Angeles Rábago, Inês C Borges, Francisco Rodrigues
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  • Splenic rupture caused by pancreatic pseudocyst successfully treated by endoscopic ultrasound-guided drainage
    Naoyuki Hasegawa, Yoshimi Ito, Masamichi Yamaura, Masato Endo, Kazunori Ishige, Kuniaki Fukuda, Ichinosuke Hyodo, Yuji Mizokami
    Clinical Journal of Gastroenterology.2020; 13(5): 981.     CrossRef
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    Aveek Mukherjee, Raisa Ghosh, Sugirdhana Velpari
    Cureus.2020;[Epub]     CrossRef
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  • 183 Download
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Original Article
Practice Patterns and Use of Endoscopic Retrograde Cholangiopancreatography in the Management of Recurrent Acute Pancreatitis
Jonathan B. Reichstein, Vaishali Patel, Parit Mekaroonkamol, Sunil Dacha, Steven A. Keilin, Qiang Cai, Field F. Willingham
Clin Endosc 2020;53(1):73-81.   Published online July 5, 2019
DOI: https://doi.org/10.5946/ce.2019.052
AbstractAbstract PDFPubReaderePub
Background
/Aims: There are conflicting opinions regarding the management of recurrent acute pancreatitis (RAP). While some physicians recommend endoscopic retrograde cholangiopancreatography (ERCP) in this setting, others consider it to be contraindicated in patients with RAP. The aim of this study was to assess the practice patterns and clinical features influencing the management of RAP in the US.
Methods
An anonymous 35-question survey instrument was developed and refined through multiple iterations, and its use was approved by our Institutional Review Board. The survey was distributed via email to 408 gastroenterologists to assess the practice patterns in the management of RAP in multiple clinical scenarios.
Results
The survey was completed by 65 participants representing 36 of the top academic/tertiary care centers across the country. Approximately 90.8% of the participants indicated that they might offer or recommend ERCP in the management of RAP. Multinomial logistic regression analysis revealed that ductal dilatation and presence of symptoms were the most predictive variables (p<0.001) for offering ERCP.
Conclusions
A preponderance of the respondents would consider ERCP among patients with RAP presenting to tertiary care centers in the US. Ductal dilatation, presence of symptoms, and pancreas divisum significantly increased the likelihood of a recommendation for ERCP

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  • Controversies in ERCP: Technical aspects
    ChristophF Dietrich, NoorL Bekkali, Sean Burmeister, Yi Dong, SimonM Everett, Michael Hocke, Andre Ignee, Wei On, Srisha Hebbar, Kofi Oppong, Siyu Sun, Christian Jenssen, Barbara Braden
    Endoscopic Ultrasound.2022; 11(1): 27.     CrossRef
  • Controversies in ERCP: Indications and preparation
    ChristophF Dietrich, NoorL Bekkali, Sean Burmeister, Yi Dong, SimonM Everett, Michael Hocke, Andre Ignee, Wei On, Srisha Hebbar, Kofi Oppong, Siyu Sun, Christian Jenssen, Barbara Braden
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    Tae Yoon Lee, Takuji Iwashita
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Case Report
Duodenal Stricture due to Necrotizing Pancreatitis following Endoscopic Ultrasound-Guided Ethanol Ablation of a Pancreatic Cyst: A Case Report
Jung Won Chun, Sang Hyub Lee, Jin Ho Choi, Woo Hyun Paik, Ji Kon Ryu, Yong-Tae Kim
Clin Endosc 2019;52(5):510-515.   Published online July 4, 2019
DOI: https://doi.org/10.5946/ce.2018.191
AbstractAbstract PDFPubReaderePub
The frequency of incidental detection of pancreatic cystic lesions (PCLs) is increasing because of the frequent use of cross-sectional imaging. The appropriate treatment for PCLs is challenging, and endoscopic ultrasound-guided ablation for PCLs has been reported in several studies. Although the feasibility and efficacy of this therapeutic modality have been shown, the safety issues associated with the procedure are still a concern. We present a case of a 61-year-old man who underwent ultrasound-guided ethanol ablation for PCL and needed repeated endoscopic balloon dilatation for severe duodenal stricture caused by necrotizing pancreatitis after the cyst ablation therapy.

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  • Benign Duodenal Stricture Treated with Surgical Correction and Dietary Therapy in a Golden Retriever
    John C. Rowe, Alice A. Huang, Jin Heo, Nolie K. Parnell, Adam J. Rudinsky
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    Chen Du, Ning-Li Chai, En-Qiang Linghu, Hui-Kai Li, Xiu-Xue Feng
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Original Articles
Risk Factors for Pancreatitis and Cholecystitis after Endoscopic Biliary Stenting in Patients with Malignant Extrahepatic Bile Duct Obstruction
Ga Hee Kim, Si Kyong Ryoo, Jae Keun Park, Joo Kyung Park, Kwang Hyuck Lee, Kyu Taek Lee, Jong Kyun Lee
Clin Endosc 2019;52(6):598-605.   Published online May 28, 2019
DOI: https://doi.org/10.5946/ce.2018.177
AbstractAbstract PDFPubReaderePub
Background
/Aims: For the treatment of malignant biliary obstruction, endoscopic retrograde biliary drainage (ERBD) has been widely accepted as a standard procedure. However, post-ERBD complications can affect the lives of patients. The purpose of this study was to identify the predictive factors for these complications, including the patient’s status, cancer status, and stent type.
Methods
This was a retrospective analysis conducted in a single tertiary hospital from January 2007 to July 2017. The following variables were evaluated: sex, age, body mass index, cancer type, history of pancreatitis, gallbladder stone, previous biliary stenting, precut papillotomy, stent type, contrast injection into the pancreatic duct or gallbladder, cystic duct invasion by the tumor, and occlusion of the cystic duct orifice by a metal stent.
Results
Multivariate analysis showed that contrast injection into the pancreatic duct was a risk factor for pancreatitis. Patients with a history of bile drainage showed a lower risk of pancreatitis. For cholecystitis, the analysis revealed contrast injection into the gallbladder and cystic duct invasion by the tumor as important predictive factors. Metal stents showed a greater risk of post-procedure pancreatitis than plastic stents, but did not affect the incidence of cholecystitis.
Conclusions
Considering that contrast injection is the most important factor for both complications, a careful approach by the physician is essential in preventing the occurrence of any complications. Further, choosing the type of stent is an important factor for patients at a risk of post-procedure pancreatitis.

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  • Risk factors for biliary tract events during elective cholecystectomy waiting time after endoscopic retrograde cholangiopancreatography for choledocholithiasis
    Tatsunori Satoh, Junichi Kaneko, Shinya Kawaguchi, Yuya Ishiguro, Shinya Endo, Naofumi Shirane, Hideyuki Kanemoto, Takanori Yamada, Kazuya Ohno
    DEN Open.2025;[Epub]     CrossRef
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    Woo Hyun Paik, Do Hyun Park
    Gastrointestinal Endoscopy Clinics of North America.2024; 34(1): 127.     CrossRef
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    Tsuyoshi Hamada, Koichiro Yasaka, Yousuke Nakai, Rintaro Fukuda, Ryunosuke Hakuta, Kazunaga Ishigaki, Sachiko Kanai, Kensaku Noguchi, Hiroki Oyama, Tomotaka Saito, Tatsuya Sato, Tatsunori Suzuki, Naminatsu Takahara, Hiroyuki Isayama, Osamu Abe, Mitsuhiro
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    Jing Song, Jun Deng, Feng Wen, Piero Chirletti
    Gastroenterology Research and Practice.2023; 2023: 1.     CrossRef
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    Nga T. Nguyen, Hasan A. Khan, Kian Abdul-Baki, Woongsoon Choi, Neel K. Shroff, Zahra Akhtar, Peeyush Bhargava
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    Sam Z. Thalji, Deemantha Fernando, Kulwinder S. Dua, Srivats Madhavan, Phillip Chisholm, Zachary L. Smith, Mohammed Aldakkak, Kathleen K. Christians, Callisia N. Clarke, Ben George, Mandana Kamgar, Beth A. Erickson, William A. Hall, Douglas B. Evans, Susa
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  • Can the laser‐cut covered self‐expandable metallic stent be the first choice for patients with unresectable distal malignant biliary obstruction? (with video)
    Yuki Tanisaka, Masafumi Mizuide, Akashi Fujita, Tomoya Ogawa, Hiromune Katsuda, Youichi Saito, Kazuya Miyaguchi, Ryuichiro Araki, Shomei Ryozawa
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    Woosun Choi, Dong Il Gwon, Jong Woo Kim, Jin Hyoung Kim, Ji Hoon Shin, Gi-Young Ko, Joonho Hur
    Acta Radiologica.2022; 63(10): 1315.     CrossRef
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    Surinder Singh Rana, Jimil Shah, Harish Bhujade, Ujjwal Gorsi, Mandeep Kang, Rajesh Gupta
    Journal of Digestive Endoscopy.2022; 13(02): 082.     CrossRef
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    Akihisa Ohno, Nao Fujimori, Toyoma Kaku, Masayuki Hijioka, Ken Kawabe, Naohiko Harada, Makoto Nakamuta, Takamasa Oono, Yoshihiro Ogawa
    Clinical Endoscopy.2022; 55(6): 784.     CrossRef
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    Mamoru Takenaka, Masatoshi Kudo
    Clinical Endoscopy.2022; 55(6): 757.     CrossRef
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    Masahiro Umemura, Eri Shimura, Yusuke Asai, Atsushi Tsuji, Masafumi Nishino, Yurimi Takahashi, Yuzo Sasada, Yasuhiko Saida, Kazuhito Kawata, Ken Sugimoto, Takanori Yamada
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    Masafumi Watanabe, Kosuke Okuwaki, Jun Woo, Mitsuhiro Kida, Hiroshi Imaizumi, Tomohisa Iwai, Hiroshi Yamauchi, Toru Kaneko, Rikiya Hasegawa, Takahiro Kurosu, Naoki Minato, Hiroki Haradome, Wasaburo Koizumi
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    Ming‐Xing Xia, Yi‐Feng Zhou, Ming Zhang, Wei Wang, Jun Wu, Tian‐Tian Wang, Xiao‐Feng Zhang, Bing Hu
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    Woo Hyun Paik, Yong-Tae Kim
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A Nationwide Assessment of the “July Effect” and Predictors of Post-Endoscopic Retrograde Cholangiopancreatography Sepsis at Urban Teaching Hospitals in the United States
Rupak Desai, Upenkumar Patel, Shreyans Doshi, Dipen Zalavadia, Wardah Siddiq, Hitanshu Dave, Mohammad Bilal, Vikas Khullar, Hemant Goyal, Madhav Desai, Nihar Shah
Clin Endosc 2019;52(5):486-496.   Published online May 27, 2019
DOI: https://doi.org/10.5946/ce.2018.190
AbstractAbstract PDFPubReaderePub
Background
/Aims: To analyze the incidence of post-endoscopic retrograde cholangiopancreatography (ERCP) sepsis in the early (July to September) and later (October to June) academic months to assess the “July effect”.
Methods
The National Inpatient Sample (2010–2014) was used to identify ERCP-related adult hospitalizations at urban teaching hospitals by applying relevant procedure codes from the International Classification of Diseases, 9th revision, Clinical Modification. Post-ERCP outcomes were compared between the early and later academic months. A multivariate analysis was performed to evaluate the odds of post-ERCP sepsis and its predictors.
Results
Of 481,193 ERCP procedures carried out at urban teaching hospitals, 124,934 were performed during the early academic months. The demographics were comparable for ERCP procedures performed during the early and later academic months. A higher incidence (9.4% vs. 8.8%, p<0.001) and odds (odds ratio [OR], 1.07) of post-ERCP sepsis were observed in ERCP performed during the early academic months. The in-hospital mortality rate (7% vs. 7.5%, p=0.072), length of stay, and total hospital charges in patients with post-ERCP sepsis were also equivalent between the 2 time points. Pre-ERCP cholangitis (OR, 3.20) and post-ERCP complications such as cholangitis (OR, 6.27), perforation (OR, 3.93), and hemorrhage (OR, 1.42) were significant predictors of higher post-ERCP sepsis in procedures performed during the early academic months.
Conclusions
The July effect was present in the incidence of post-ERCP sepsis, and academic programs should take into consideration the predictors of post-ERCP sepsis to lower health-care burden.

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    Zahra Shahin, Gulzar H. Shah, Bettye A. Apenteng, Kristie Waterfield, Hani Samawi
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    Oscar Cahyadi, Nadeem Tehami, Enrique de-Madaria, Keith Siau
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    Susan Hutfless, Yasutoshi Shiratori, Daniel Chu, Simon Liu, Anthony Kalloo
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  • 84 Download
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The Utility of Endoscopic Ultrasound in Patients with Isolated Elevations in Serum Amylase and/or Lipase
Lalitha M. Sitaraman, Amit H. Sachdev, Tamas A. Gonda, Amrita Sethi, John M. Poneros, Frank G. Gress
Clin Endosc 2019;52(2):175-181.   Published online January 16, 2019
DOI: https://doi.org/10.5946/ce.2018.110
AbstractAbstract PDFPubReaderePub
Background
/Aims: The aim of this study was to describe the diagnostic yield of endoscopic ultrasound (EUS) in patients with isolated elevated levels of amylase and/or lipase.
Methods
A retrospective chart review was conducted at a large academic medical center from 2000 to 2016. Patients were selected based on having elevated amylase, lipase, or both, but without a diagnosis of pancreatitis or known pancreatobiliary disease. Patients were excluded if they had abnormal liver function tests or abnormal imaging of the pancreas.
Results
Of 299 EUS procedures performed, 38 met inclusion criteria. Symptoms were present in 31 patients, most frequently abdominal pain (87%). In 20 patients (53%), initial EUS most commonly found chronic pancreatitis (n=7; 18%), sludge (5; 13%), or new diagnosis of pancreas divisum (3; 8%). In the asymptomatic patients (7), 3 had a finding on EUS, most importantly sludge (2), stone (1), and pancreas divisum (1). No patients were diagnosed with a mass or pancreatic cyst. During the follow up period, 6 patients (22%) had cholecystectomy.
Conclusions
In our study of patients with isolated elevations in amylase and/or lipase without acute pancreatitis who underwent EUS, approximately 50% had a pancreatobiliary finding, most commonly chronic pancreatitis or biliary sludge.

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  • Endosonographic features in patients with non-alcoholic early chronic pancreatitis improved with treatment at one year follow up
    Kazutoshi Higuchi, Seiji Futagami, Hiroshi Yamawaki, Makoto Murakami, Kumiko Kirita, Shuhei Agawa, Go Ikeda, Hiroto Noda, Yasuhiro Kodaka, Nobue Ueki, Keiko Kaneko, Katya Gudis, Ryuji Ohashi, Katsuhiko Iwakiri
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    Jung Wan Choe, Jong Jin Hyun
    Clinical Endoscopy.2019; 52(2): 97.     CrossRef
  • 9,538 View
  • 162 Download
  • 3 Web of Science
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Case Report
Endoscopic Ultrasound in the Diagnosis of Pancreatoduodenal Groove Pathology: Report of Three Cases and Brief Review of the Literature
Inés C. Oría, Juan E. Pizzala, Augusto M. Villaverde, Juan C. Spina, Analía V. Pasqua, Julio C. Lazarte, Oscar M. Mazza, Mariano M. Marcolongo
Clin Endosc 2019;52(2):196-200.   Published online November 9, 2018
DOI: https://doi.org/10.5946/ce.2018.097
AbstractAbstract PDFPubReaderePub
The pancreatoduodenal groove is a small area where pathologic processes involving the distal bile duct, duodenum, pancreatic head, ampulla of Vater, and retroperitoneum converge. Despite great advances in imaging techniques, a definitive preoperative diagnosis is challenging because of the complex anatomy of this area. Therefore, surgical intervention is frequently required because of the inability to completely exclude malignancy.
We report 3 cases of patients with different groove pathologies but similar clinical and imaging presentation, and show the essential role of endoscopic ultrasound (EUS) in making a specific preoperative diagnosis, excluding malignancy in the first case, changing diagnosis in the second case, and confirming malignancy in the third case. EUS was a fundamental tool in this cohort of patients, not only because of its ability to provide superior visualization of a difficult anatomical region, but because of the ability to guide precise, realtime procedures, such as fine-needle aspiration.

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    Xiaoyuan Fan, Chihong Shi, Dewen Lu
    Experimental and Therapeutic Medicine.2024;[Epub]     CrossRef
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    Catarina Neto do Nascimento, Carolina Palmela, António Sampaio Soares, Maria Lobo Antunes, Catarina Andrade Fidalgo, Luísa Glória
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    Barbara A Centeno
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    Yu Mo She, Nan Ge
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Original Article
Pancreatic Necrosectomy through Sinus Tract Endoscopy
Mahesh Kumar Goenka, Usha Goenka, Md.Yasin Mujoo, Indrajit Kumar Tiwary, Sanjay Mahawar, Vijay Kumar Rai
Clin Endosc 2018;51(3):279-284.   Published online January 4, 2018
DOI: https://doi.org/10.5946/ce.2017.066
AbstractAbstract PDFPubReaderePub
Background
/Aims: Direct endoscopic pancreatic necrosectomy is increasingly being utilized to treat infected or symptomatic walled-off necrosis (WON) located close to the stomach or duodenum. Laterally-placed WON has traditionally been treated surgically. We evaluated a less utilized technique of sinus tract endoscopy (STE) for symptomatic laterally-placed WON.
Methods
Two hundred seventy-six patients with acute pancreatitis admitted in our hospital, 32 had symptomatic or infected WON requiring intervention. Of the 12 patients with laterally placed WON, 10 were treated by STE. STE was performed with a standard adult gastroscope passed through a percutaneous tract created by the placement of a 32-Fr drain.
Results
Ten patients (7 males; mean age, 43.8 years) underwent STE. Mean number of sessions was 2.3 (range, 1–4), with mean time of 70 minutes for each session (range, 15–70 minutes). While 9 patients had complete success, 1 patient had fever and chose to undergo surgery. Two patients developed pneumoperitoneum, which was treated conservatively. There was no mortality, cutaneous fistula, or recurrence during follow-up.
Conclusions
Laterally placed WON can be successfully managed by STE performed through a percutaneously placed drain. Details of the technique and end-points of STE require further evaluation.

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    Santi Mangiafico, Helga Bertani, Flavia Pigò, Salvatore Russo, Marinella Lupo, Silvia Cocca, Giuseppe Grande, Ugo Germani, Raffaele Manta, Rita Conigliaro
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    Cecilia BINDA, Barbara PERINI, Chiara COLUCCIO, Paolo GIUFFRIDA, Stefano FABBRI, Giulia GIBIINO, Antonio VIZZUSO, Emanuela GIAMPALMA, Carlo FABBRI
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    Daniela Giraldo Campillo, Juliana Lucía Molina Valencia, Juan Camilo Ricaurte Ciro, Carlos Andrés Delgado López
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    Sohini Sameera, Tayyaba Mohammad, Kelvin Liao, Haroon Shahid, Avik Sarkar, Amy Tyberg, Michel Kahaleh
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    Mihajlo Gjeorgjievski, Abishek Bhurwal, Abhishek A. Chouthai, Abdelhai Abdelqader, Monica Gaidhane, Haroon Shahid, Amy Tyberg, Avik Sarkar, Michel Kahaleh
    Endoscopy International Open.2023; 11(03): E258.     CrossRef
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    Soumya Jagannath Mahapatra, Pramod Kumar Garg
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    Michael Hocke, Sean Burmeister, Barbara Braden, Christian Jenssen, PaoloGiorgio Arcidiacono, Julio Iglesias-Garcia, André Ignee, Alberto Larghi, Kathleen Möller, Mihai Rimbas, Sun Siyu, Giuseppe Vanella, ChristophF Dietrich
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    Birte Purschke, Louisa Bolm, Max Nikolaus Meyer, Hiroki Sato
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    Manoj A Vyawahare, Sushant Gulghane, Rajkumar Titarmare, Tushar Bawankar, Prashant Mudaliar, Rahul Naikwade, Jayesh M Timane
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    Cecilia Binda, Monica Sbrancia, Marina La Marca, Dora Colussi, Antonio Vizzuso, Matteo Tomasoni, Vanni Agnoletti, Emanuela Giampalma, Luca Ansaloni, Carlo Fabbri
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    S. V. Novikov, M. L. Rogal, R. A. Yartsev, Yu. S. Teterin
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    Hoonsub So, Seokjung Jo, Tae Jun Song
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Review
Necrotizing Pancreatitis: Current Management and Therapies
Christine Boumitri, Elizabeth Brown, Michel Kahaleh
Clin Endosc 2017;50(4):357-365.   Published online May 16, 2017
DOI: https://doi.org/10.5946/ce.2016.152
AbstractAbstract PDFPubReaderePub
Acute necrotizing pancreatitis accounts for 10% of acute pancreatitis (AP) cases and is associated with a higher mortality and morbidity. Necrosis within the first 4 weeks of disease onset is defined as an acute necrotic collection (ANC), while walled off pancreatic necrosis (WOPN) develops after 4 weeks of disease onset. An infected or symptomatic WOPN requires drainage. The management of pancreatic necrosis has shifted away from open necrosectomy, as it is associated with a high morbidity, to less invasive techniques. In this review, we summarize the current management and therapies for acute necrotizing pancreatitis.

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Case Reports
Two Cases of Plug or Stone in Remnant Intrapancreatic Choledochal Cysts Treated with Endoscopic Retrograde Cholangiopancreatography
Eunbee Kim, Min Ho Kang, Jisun Lee, Hanlim Choi, Jae-Woon Choi, Joung-Ho Han, Seon Mee Park
Clin Endosc 2017;50(5):504-507.   Published online February 16, 2017
DOI: https://doi.org/10.5946/ce.2017.012
AbstractAbstract PDFPubReaderePub
Incomplete resection of choledochal cysts (CCs) that extend deep into the pancreas can lead to protein plug or stone formation, pancreatitis, and cholangiocarcinoma. We encountered two cases of choledocholithiasis in remnant intrapancreatic CCs (IPCCs), in which the patients exhibited symptoms after 3 and 21 years of cyst excision. A 21-year-old woman who had undergone excision of a CC, as a neonate, presented with epigastric pain. Abdominal computed tomography (CT) revealed stones inside the remnant pancreatic cyst, which were removed by endoscopic retrograde cholangiopancreatography (ERCP), and her symptoms improved. A 33-year-old woman, who underwent cyst excision 3 years ago, presented with pancreatitis. Abdominal CT showed a radiolucent plug inside the remnant pancreatic cyst. The soft, whitish plug was removed by ERCP, and the pancreatitis improved. These cases indicate that plugs and stones in CCs have the same pathogenetic mechanism, and their form depends on the time since the incomplete excision surgery.

Citations

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  • Choledochal cysts – state of the art
    Thanh Liem Nguyen, V. S. Cheremnov, Yu. A. Kozlov
    Russian Journal of Pediatric Surgery.2021; 25(1): 37.     CrossRef
  • 7,292 View
  • 134 Download
  • 1 Crossref
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Mediastinal Pancreatic Pseudocysts
Krzysztof Dąbkowski, Andrzej Białek, Maciej Kukla, Janusz Wójcik, Andrzej Smereczyński, Katarzyna Kołaczyk, Tomasz Grodzki, Teresa Starzyńska
Clin Endosc 2017;50(1):76-80.   Published online September 13, 2016
DOI: https://doi.org/10.5946/ce.2016.089
AbstractAbstract PDFPubReaderePub
Mediastinal pseudocysts are a rare complication of acute pancreatitis. Lack of uniform treatment standards makes the management of this condition a clinical challenge. We report the case of a 43-year-old patient who presented with a left pleural effusion. Pleural fluid revealed a high amylase concentration consistent with a pancreaticopleural fistula. Endoscopic retrograde cholangiopancreatography (ERCP) revealed a disruption of the pancreatic duct with free outflow of contrast medium into the thoracic cavity. A pancreatic stent was placed. The second day after the ERCP, the patient developed septic shock and was admitted to the intensive care unit. Computed tomography (CT) revealed mediastinal pseudocysts and bilateral pleural effusions. After bilateral drainage of the pleural cavities, the patient improved clinically, and a follow-up CT scan showed that the fluid collection and pseudocysts had resolved. We discuss the optimal strategies for diagnosing and treating patients with pancreatic thoracic pseudocysts and fistulas, as well as review the management of these conditions.

Citations

Citations to this article as recorded by  
  • Unveiling Rare Complications: Pancreatic Pseudocysts and Monomicrobial Non-neutrocytic Bacterascites in Decompensated Cirrhosis
    Harshitha Reddy, Rushikesh H Dhondge, Sunil Kumar, Sourya Acharya
    Cureus.2024;[Epub]     CrossRef
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    Xiying Dong, Dong Wu
    Gastroenterology.2023; 164(2): 191.     CrossRef
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    Masashi Taka, Satoshi Kobayashi, Kaori Mizutomi, Dai Inoue, Shigeyuki Takamatsu, Toshifumi Gabata, Isao Matsumoto, Hiroko Ikeda, Takeshi Kobayashi, Hiroshi Minato, Hitoshi Abo
    European Journal of Radiology.2023; 162: 110767.     CrossRef
  • Mediastinal extension of pancreatic pseudocysts causing portal hypertension
    Leni Santiana, Viola Stephanie Warokko, Dikki Drajat Kusmayadi Surachman, Harry Galuh Nugraha
    Radiology Case Reports.2023; 18(11): 4226.     CrossRef
  • Acute pancreatitis: A review of diagnosis, severity prediction and prognosis assessment from imaging technology, scoring system and artificial intelligence
    Jian-Xiong Hu, Cheng-Fei Zhao, Shu-Ling Wang, Xiao-Yan Tu, Wei-Bin Huang, Jun-Nian Chen, Ying Xie, Cun-Rong Chen
    World Journal of Gastroenterology.2023; 29(37): 5268.     CrossRef
  • Mediastinal pancreatobiliary pseudocysts
    G.I. Dryazhenkov, I.G. Dryazhenkov, S.I. Balnykov, E.V. Kalashyan, A.A. Stepankov
    Khirurgiya. Zhurnal im. N.I. Pirogova.2022; (3): 56.     CrossRef
  • The Role of Endoscopic Ultrasound in the Interventional Management of Mediastinal Collections: A Narrative Review
    Julio G Velasquez-Rodriguez, Sandra Maisterra, Ricard Ramos, Ignacio Escobar, Joan B Gornals
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    Shruti Tewari, A. Sushma, Rajeev Redkar
    Journal of Indian Association of Pediatric Surgeons.2021; 26(1): 44.     CrossRef
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    L. P. Kotelnikova, S. A. Plaksin, I. G. Burnyshev, D. V. Trushnikov
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    Harshini Udayakumar, Venkatraman Indiran, Kalaichezhian Mariappan, Prabakaran Maduraimuthu
    Journal of Gastrointestinal and Abdominal Radiology.2020; 3(S 01): S54.     CrossRef
  • Mediastinal pancreatic cysts: review and own clinical observations
    L. P. Kotelnikova, S. A. Plaksin, L. I. Farshatova
    Khirurgiya. Zhurnal im. N.I. Pirogova.2019; (7): 80.     CrossRef
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    Pankaj Halder, Kartik Chandra Mandal, Bidyut Debnath, Sumedha Mukherjee
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  • Pancreaticopleural Fistula: A Review of Imaging Diagnosis and Early Endoscopic Intervention
    Ali Kord Valeshabad, Jennifer Acostamadiedo, Lekui Xiao, Winnie Mar, Karen L. Xie
    Case Reports in Gastrointestinal Medicine.2018; 2018: 1.     CrossRef
  • 7,991 View
  • 204 Download
  • 9 Web of Science
  • 13 Crossref
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Acute Pancreatitis Following Endoscopic Ampullary Biopsies without Attempted Cannulation of the Ampulla of Vater
Spyridon Michopoulos, Dimitra Kozompoli, Sparti Ntai, Georgios Kalantzis, Evanthia Zampeli, Kalliopi Petraki
Clin Endosc 2016;49(6):575-578.   Published online July 20, 2016
DOI: https://doi.org/10.5946/ce.2016.043
AbstractAbstract PDFPubReaderePub
A 51-year-old man underwent diagnostic work-up for an abnormal-appearing ampulla of Vater. Three hours after biopsy of the ampulla, the patient presented with intense symptoms suggesting acute pancreatitis, which was later confirmed with laboratory and radiographic examinations. Other causes were excluded and the acute pancreatitis was considered a procedural complication. This is a rarely reported complication that must be taken into consideration when biopsies are performed in the ampulla of Vater.

Citations

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  • Readmission rate and complications following biopsy of the ampulla of Vater—A retrospective data analysis
    Sam Rosella, Leonardo Zorron Cheng Tao Pu, Jonathan Ng, Kim Hay Be, Rhys Vaughan, Sujievvan Chandran, Marios Efthymiou
    JGH Open.2023; 7(4): 299.     CrossRef
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    Nidhi Mariam George, Nanda Amarnath Rajesh, Tharun Ganapathy Chitrambalam
    World Journal of Gastrointestinal Endoscopy.2023; 15(8): 540.     CrossRef
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    E. Soons, T. M. Bisseling, M. C. A. van Kouwen, G. Möslein, P. D. Siersema
    United European Gastroenterology Journal.2021; 9(4): 461.     CrossRef
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    Yu Ishibashi, Tomohisa Iwai, Eiji Miyata, Rikiya Hasegawa, Toru Kaneko, Koji Yamauchi, Kosuke Okuwaki, Hiroshi Imaizumi, Mitsuhiro Kida, Wasaburo Koizumi
    Progress of Digestive Endoscopy.2018; 92(1): 108.     CrossRef
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  • 103 Download
  • 3 Web of Science
  • 4 Crossref
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