A simple way of avoiding post-ERCP pancreatitis - 25/08/11
Reprint requests: Fausto Lella, MD, Department of Gastroenterology, Policlinico San Marco, Corso Europa 7-24040 Zingonia (BG), Italy.Zingonia, Italy
Abstract |
Background |
Pancreatitis occurs in up to 30% of patients who undergo ERCP. This study tested the hypothesis that post-ERCP pancreatitis can be avoided by initially accessing the bile duct with a soft-tipped Teflon tracer 0.035-inch guidewire.
Methods |
A single endoscopist performed ERCP in 400 consecutive patients with pancreatobiliary disease who were randomized to two groups. In Group A (200 patients), the bile duct was first accessed by insertion of a soft-tipped Teflon tracer (diameter 0.035 inch) guidewire through a 6F, double channel sphincterotome, followed by cannulation, injection of contrast, and sphincterotomy. In Group B (200 patients), the bile duct was opacified by using traditional methods of cannulation.
Results |
No case of acute pancreatitis was detected in Group A, whereas, 8 cases were observed in Group B (6 mild, one moderate, one severe) (p < 0.01). In 9 patients in Group A vs. 39 in Group B (p < 0.001), the serum amylase rose to more than 5 times the upper normal limit during the 24 hours after the procedure. There was no procedure-related mortality.
Conclusions |
Accessing the bile duct with a soft-tipped tracer guidewire prevents post-ERCP pancreatitis.
El texto completo de este artículo está disponible en PDF.Esquema
Vol 59 - N° 7
P. 830-834 - juin 2004 Regresar al número
Artículo precedente
- Macrocystic pancreatic cystadenoma: the role of EUS and cyst fluid analysis in distinguishing mucinous and serous lesions
- Dermot O'Toole, Laurent Palazzo, Pascal Hammel, Lamia Ben Yaghlene, Anne Couvelard, Michèle Felce-Dachez, Monique Fabre, Alain Dancour, Alain Aubert, Alain Sauvanet, Frédérique Maire, Philippe Lévy, Philippe Ruszniewski
- White specks in the esophageal mucosa: an endoscopic manifestation of non-reflux eosinophilic esophagitis in children
- Joel R Lim, Sandeep K Gupta, Joseph M Croffie, Marian D Pfefferkorn, Jean P Molleston, Mark R Corkins, Mary M Davis, Philip P Faught, Steven J Steiner, Joseph F Fitzgerald
Bienvenido a EM-consulte, la referencia de los profesionales de la salud.
El acceso al texto completo de este artículo requiere una suscripción.
¿Ya suscrito a @@106933@@ revista ?