Bleeding risk in endoscopic retrograde cholangiopancreatography. Impact of the use of antithrombotic drugs

Parras, Fernando Alberca de Las; Valenzuela, Juan Egea; Álvarez, F. Carballo

doi:10.17235/reed.2017.4358/2016

Cited by 7 publications

(2 citation statements)

References 87 publications

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“…Papillectomy has been described as a high‐risk procedure for bleeding 22 and pancreatitis. In our report, the complication rate was 20.5% with no differences in intra‐/extraductal groups.…”

Section: Discussionmentioning

confidence: 99%

Combined excision and ablation of ampullary tumors with biliary or pancreatic intraductal extension is effective even in malignant neoplasms

Pérez-Cuadrado-Robles

Piessevaux

Moreels

et al. 2019

UEG Journal

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Background: The feasibility and outcome of endoscopic resection in ampullary tumors with intraductal growth remains unclear. Objective: To assess the safety, feasibility and outcomes of these patients treated by thermal ablation. Methods: Retrospective observational study. All consecutive patients who underwent an endoscopic snare papillectomy with a 6-month minimum follow-up were included. Ablation was performed with cystotomes and soft/forced coagulation. Successful endoscopic treatment was defined as no adenomatous residual tissue or recurrence observed at follow-up. Results: Of 86 patients presenting with an ampullary tumor, 73 (58 AE 14 years old, 49% men, 34% familial adenomatous polyposis) (median tumor size: 20 mm, range: 8-80) were included. En bloc and curative resection rates were achieved in 46.6% and 83.6%, respectively. Intraductal ingrowth was seen in 18 (24.7%) patients and histologically confirmed in 12 (16.4%). Intraductal ablation achieved a 100% success rate, with a 20-month median follow-up. Most of these patients had malignant forms (n ¼ 8, 66.7%), with a higher adenocarcinoma rate (33.3% versus 3.3%, p ¼ 0.001) compared to extraductal tumors. Overall, there was a 20.5% complication rate with no significant differences between both groups (p ¼ 0.676). Conclusions: Intraductal ablation achieves a high therapeutic success rate in ampullary tumors with 20 mm ductal extension, even in malignant forms or biliary and pancreatic involvement. The technique is feasible, cheap and safe and may avoid major surgery. Key summary1. Summary of the established knowledge on this subject . Endoscopic papillectomy can offer a curative resection in 67-92% of cases.. Intraductal extension has been described as a relative contraindication for endoscopic resection and is associated with lower curative resection rates and incomplete adenoma removal. . There is no consensus on the indications for endoscopic papillectomy in intraductal extension of ampullary neoplasms and the maximum intraductal involvement able to be resected endoscopically is unknown.

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Section: Discussionmentioning

confidence: 99%

Combined excision and ablation of ampullary tumors with biliary or pancreatic intraductal extension is effective even in malignant neoplasms

Pérez-Cuadrado-Robles

Piessevaux

Moreels

et al. 2019

UEG Journal

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“…Estándar mínimo: 95%. Los antiagregantes y/o anticoagulantes tienen un impacto directo en la incidencia de complicaciones post-CPRE, por lo que es fundamental conocer si el paciente los recibe para tomar las medidas correspondientes basadas en recomendaciones estandarizadas [30][31][32][33] .…”

Section: Previo a La Realización De La Cpre Es Importante Conocer Y D...unclassified

Consenso de indicadores de calidad en la atención en colangiopancreatografía retrógrada endoscópica

Blanco-Vela¹,

Peláez-Luna²,

Martínez-García³

et al. 2022

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Trans-papillary endoscopic surgery: predictors of complications and prevention of their development

Romashchenko¹,

Майстренко²,

Filin³

et al. 2021

Endosk. khir.

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Bleeding risk in endoscopic retrograde cholangiopancreatography. Impact of the use of antithrombotic drugs

Abstract: Seven conclusions regarding the risk factors for bleeding and the impact of antithrombotic drugs have been defined.

Cited by 7 publications

References 87 publications

Combined excision and ablation of ampullary tumors with biliary or pancreatic intraductal extension is effective even in malignant neoplasms

Combined excision and ablation of ampullary tumors with biliary or pancreatic intraductal extension is effective even in malignant neoplasms

Consenso de indicadores de calidad en la atención en colangiopancreatografía retrógrada endoscópica

Trans-papillary endoscopic surgery: predictors of complications and prevention of their development

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