Air cholangiogram: a new technique for biliary imaging during ERCP

Sud, Randhir; Puri, Rajesh; Hussain, Sabir; Kumar, Mandhir; Thawrani, Amit

doi:10.1016/j.gie.2010.02.042

Cited by 21 publications

(17 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…al. demonstrated similar results [28] . Although air cholangiogram is effective and can decrease post-ERCP cholangitis risk, air embolism is a rare and potentially fatal complication.…”

Section: Discussionsupporting

confidence: 73%

CO2 Cholangiography Reduce Cholangitis Risk in Patients with Bismuth Type IV Hilar Biliary Obstruction during ERCP

zhang

Ding

Liu

et al. 2020

Preprint

View full text Add to dashboard Cite

Backgrounds: Endoscopic palliation in hilar obstruction requires endoscopic retrograde cholangiopancreatography (ERCP), whereas cholangitis could be induced by contrast injection. Post ERCP cholangitis risk is particularly high in Bismuth type IV hilar obstruction, and the risk is further increased if the contrast could not be drained. The aim of this study is to evaluate the cholangitis risks associated with contrast agent, air and CO 2 injection in type IV hilar lesions. Methods : The authors retrospectively evaluated the utility of contrast, air and CO 2 cholangiography in consecutive 70 patients with type IV hilar obstruction. The patients were divided into 3 groups based on the agent used: A) contrast (n=22), B) air (n=18), and C) CO 2 (n=30). Prior to ERCP, MRCP was obtained in all patients to guide endoscopic intervention. Results : At baseline, there was no significant difference in patient’s age, gender, symptoms, liver function tests between different groups ( p ＞0.05). The complication rates in group B and C were significantly lower than that in group A (27.8% and 26.7% versus 63.6%, p ＜0.05). Except cholangitis risk ( p ＜0.05), no significant difference was found in post ERCP pancreatitis and bleeding risks (both p ＞0.05) between the 3 groups. After ERCP, the mean hospital stay duration was shorter in group B and C compared with group A ( p ＜0.05). However, the difference of one month mortality between 3 groups was not significant ( p ＞0.05). There was no significant difference between group B and C in primary end points. Conclusions : CO 2 cholangiography based ERCP is safer and should be utilized to reduce the risk of post-ERCP cholangitis in typer IV hilar obstruction.

show abstract

“…al. demonstrated similar results [28] . Although air cholangiogram is effective and can decrease post-ERCP cholangitis risk, air embolism is a rare and potentially fatal complication.…”

Section: Discussionsupporting

confidence: 73%

CO2 Cholangiography Reduce Cholangitis Risk in Patients with Bismuth Type IV Hilar Biliary Obstruction during ERCP

zhang

Ding

Liu

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…One pre-procedural strategy to reduce and prevent this complication is the use of magnetic resonance cholangiopancreatography, and limiting the use of contrast injection into segments previously accessed with a guide wire has been shown to considerably reduce risk. [21][22][23]…”

Section: Discussionmentioning

confidence: 99%

An unexpected case of iatrogenic Escherichia coli endogenous pan-endopthalmitis after ERCP-associated biliary sepsis: A case report

Ansari¹,

Lai

Tejwani

2019

European Journal of Ophthalmology

View full text Add to dashboard Cite

Introduction: Endogenous endopthalmitis is a diagnostically challenging ophthalmic and medical emergency. It has the ability to manifest at any age and is associated with a number of predisposing factors. The rapid progression of disease poses catastrophic risk for adverse outcomes both localised and systemic. To our knowledge, we describe the first reported iatrogenic case of endogenous Escherichia coli–induced endopthalmitis progressing to pan-endopthalmitis as a consequence of endoscopic retrograde cholangiopancreatography. Diagnosis, Interventions and Outcomes: The patient presented with reduced visual acuity and painless red eye; however, apart from biochemistry results suggesting biliary sepsis, no other clinical features of acute disease were noted. Despite rigorous systemic and intravitreal treatment, the rapid progression of disease led to irreversible damage to the eye. Conclusion: Clinicians must maintain a very high index of suspicion when encountering patients after interventional procedures, as misdiagnosis by trained ophthalmologists for endogenous endopthalmitis remains a common occurrence. Prompt identification and diagnosis ensured our patient avoided evisceration and early ophthalmic biopsies guaranteed the correct systemic intervention was started to address the severe subsequent septicaemia.

show abstract

“…An air cholangiogram is shown in Figure 5. The usefulness of air cholangiography was first reported by Sud et al [34] in 2010. Zhang et al [35] recently demonstrated a significantly lower rate of post-ERCP cholangitis in patients who underwent CO 2 cholangiography compared to a conventional contrast study (5.6% vs. 33.3%, p=0.04).…”

Section: Endoscopic Biliary Drainagementioning

confidence: 97%

Current Status of Endoscopic Treatment of Advanced Hilar Cholangiocarcinoma

Prachayakul¹

2014

J Gastroint Dig Syst

View full text Add to dashboard Cite

Cholangiocarcinoma is a high-mortality primary hepatic malignancy. A higher incidence of cholangiocarcinoma was reported in Asia, especially Southeast Asia, than in Western countries. Hilar cholangiocarcinoma is a specific type of extrahepatic cholangiocarcinoma that involves the hepatic hilum and has a worse prognosis. More than half of the patients with jaundice are inoperable at the time of first diagnosis. Therefore, biliary drainage is the mainstay of palliative treatment in these patients. Endoscopic biliary drainage via endoscopic retrograde cholangiopancreatography, the modality of choice, for the advanced hilar type is more difficult and complex than those in distal cholangiocarcinoma. Endoscopists should consider many factors before selecting the most appropriate treatment for each patient. Here we discuss the factors systematically. In cases of transpapillary approach failure, other therapeutic modalities should be considered. Percutaneous transhepatic biliary drainage is the most popular method in such cases. At the present, endoscopic ultrasound-guided biliary drainage, especially hepaticogastrostomy, is an alternative procedure with the same efficacy and low complications when it was carried out in the expert hands. Furthermore, recent locoregional therapies for tumor control including trans-luminal photodynamic therapy and radiofrequency ablation also benefit these patients.

show abstract

Air cholangiogram: a new technique for biliary imaging during ERCP

Cited by 21 publications

References 22 publications

CO2 Cholangiography Reduce Cholangitis Risk in Patients with Bismuth Type IV Hilar Biliary Obstruction during ERCP

CO2 Cholangiography Reduce Cholangitis Risk in Patients with Bismuth Type IV Hilar Biliary Obstruction during ERCP

An unexpected case of iatrogenic Escherichia coli endogenous pan-endopthalmitis after ERCP-associated biliary sepsis: A case report

Current Status of Endoscopic Treatment of Advanced Hilar Cholangiocarcinoma

Contact Info

Product

Resources

About