Comparison between emergency and elective endoscopic sphincterotomy in patients with acute cholangitis due to choledocholithiasis: is emergency endoscopic sphincterotomy safe?

Ueki, Toshiharu; Otani, Keisuke; Fujimura, Naruhito; Shimizu, Aiko; Otsuka, Yuichiro; Kawamoto, Kazuyuki; Matsui, Toshiyuki

doi:10.1007/s00535-009-0100-4

Cited by 18 publications

(18 citation statements)

References 18 publications

(28 reference statements)

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“…The incidence of post-EST pancreatitis is largely dependent upon the skill of the endoscopist, in addition to factors related to the host. Endoscopists must aim to improve their technique and fully utilize their abilities under an adequate guidance system [25]. …”

Section: Discussionmentioning

confidence: 99%

Risk factors for post-ERCP pancreatitis: a systematic review of clinical trials with a large sample size in the past 10 years

et al. 2014

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BackgroundPost- endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) is the most common and most severe complication associated with diagnostic and therapeutic ERCP. A multivariate analysis of risk factors for PEP is essential for identifying patients at high risk and subsequently choosing other suitable diagnoses.MethodsPertinent publications were identified through systematic searches of MEDLINE, Elsevier, and Springer; we performed a systematic review of 12 clinical studies published in the past ten years, selected out of 451 reviewed articles, in which risk factors for pancreatitis were identified. Seven probable risk factors were evaluated, and outcomes expressed in the case of dichotomous variables, as an odds ratio (OR) (with a 95% confidence interval, 95% CI).ResultsWhen the risk factors were analyzed, the OR for female gender was 1.40 (95% CI 1.24 to 1.58); the OR for previous PEP was 3.23 (95% CI 2.48 to 4.22); the OR for previous pancreatitis was 2.00 (95% CI 1.72 to 2.33); the OR for endoscopic sphincterotomy was 1.42 (95% CI 1.14 to 1.78); the OR for precut sphincterotomy was 2.11 (95% CI 1.72 to 2.59); the OR for Sphincter of Oddi dysfunction was 4.37 (95% CI 3.75 to 5.09); and the OR for non-prophylactic pancreatic duct stent was 2.10 (95% CI 1.63 to 2.69).ConclusionsIt appears that female gender, previous PEP, previous pancreatitis, endoscopic sphincterotomy, precut sphincterotomy, Sphincter of Oddi dysfunction, and non-prophylactic pancreatic duct stent are the risk factors for post-ERCP pancreatitis.

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Section: Discussionmentioning

confidence: 99%

Risk factors for post-ERCP pancreatitis: a systematic review of clinical trials with a large sample size in the past 10 years

et al. 2014

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“…However, the hospital stay will be increased [141]. On the other hand, it has been reported that drainage, such as ENBD, is not required if stones are removed completely after EST in a one-stage procedure [142]. Short-term stenting is required to prevent cholangitis if any residual stones are suspected.…”

Section: Commentarymentioning

confidence: 99%

Evidence-based clinical practice guidelines for cholelithiasis 2016

Tazuma

Unno²,

Igarashi³

et al. 2016

J Gastroenterol

213

178

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Cholelithiasis is one of the commonest diseases in gastroenterology. Remarkable improvements in therapeutic modalities for cholelithiasis and its complications are evident. The Japanese Society of Gastroenterology has revised the evidence-based clinical practice guidelines for cholelithiasis. Forty-three clinical questions, for four categories-epidemiology and pathogenesis, diagnosis, treatments, and prognosis and complications-were selected, and a literature search was performed for the clinical questions with use of the MEDLINE, Cochrane, and Igaku Chuo Zasshi databases for the period between 1983 and June 2012. The guidelines were developed with use of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. This article preferentially describes the clinical management of cholelithiasis and its complications. Following description of the diagnosis performed stepwise through imaging modalities, treatments of cholecystolithiasis, choledocholithiasis, and hepatolithiasis are introduced along with a flowchart. Since there have been remarkable improvements in endoscopic treatments and surgical techniques, the guidelines ensure flexibility in choices according to the actual clinical environment. The revised clinical practice guidelines are appropriate for use by clinicians in their daily practice.

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“…Additional studies have examined the adverse outcomes of subjects undergoing emergent versus elective ERCP, showing some increased incidence of pancreatitis in the emergent group. 18 Our study did demonstrate 15 complications of biliary decompression including summarized in table 5. There were no differences seen in complications between the quartiles.…”

Section: Discussionmentioning

confidence: 65%

Does the urgency of endoscopic retrograde cholangiopancreatography (ercp)/percutaneous biliary drainage (pbd) impact mortality and disease related complications in ascending cholangitis? (deim-i study)

Mok¹,

Mannino²,

Malin³

et al. 2012

jig

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Comparison between emergency and elective endoscopic sphincterotomy in patients with acute cholangitis due to choledocholithiasis: is emergency endoscopic sphincterotomy safe?

Abstract: Combination therapy comprising EBD plus EST as the initial treatment for patients with moderate acute cholangitis due to choledocholithiasis was safe and did not prolong the period of hospitalization.

Cited by 18 publications

References 18 publications

Risk factors for post-ERCP pancreatitis: a systematic review of clinical trials with a large sample size in the past 10 years

Risk factors for post-ERCP pancreatitis: a systematic review of clinical trials with a large sample size in the past 10 years

Evidence-based clinical practice guidelines for cholelithiasis 2016

Does the urgency of endoscopic retrograde cholangiopancreatography (ercp)/percutaneous biliary drainage (pbd) impact mortality and disease related complications in ascending cholangitis? (deim-i study)

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