Hyperamylasaemia and Acute Pancreatitis Following Endoscopic Retrograde Cholangiopancreatography

LaFerla, Godfrey; Gordon, Stuart R.; Archibald, M; Wr, Murray

doi:10.1097/00006676-198603000-00009

Cited by 74 publications

(32 citation statements)

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“…Despite this temporary increase in serum amylase there was no clinical, biochemical or histological evidence to suggest acute generalized pancreatitis. Indeed, increases in serum amylase concentration are recognised sequelae to any manipulation of the pancreas, diagnostic ERCP for example [26] . Interestingly, in this study the peak mean amylase concentration was greatest in the control group rather than in either of the treatment groups, although this difference did not reach statistical signifi cance.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Perductal Electrolytic Ablation of the Pancreas: Experimental Studies of Morbidity and Mortality

Morrison¹,

Court²,

Teague³

et al. 2005

Dig Dis

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Background: Palliation of pancreatic cancer remains the only option for the majority of patients. Palliative techniques such as surgical bypass and endoscopic retrograde cholangiopancreatography (ERCP) with stenting are not ideal. The ‘ideal’ palliative technique would combine the efficacy of surgery with the minimal complications of an endoscopic procedure. Endoscopically delivered perductal electrolytic ablation of pancreatic lesions has the potential to meet these criteria. Methods: Fifteen pigs were used. The pancreatic duct was cannulated with an electrolysis catheter. Animals were randomised to either: controls, treatment 2-week survivor or treatment 8-week survivor. An electrolytic dose was administered to the treatment animals. Post-operatively, serum amylase and leucocyte count were assessed. Pancreata were histologically examined to detect evidence of acute pancreatitis. Results: Electrolysis was well tolerated. There was no difference in post-operative hyperamylasaemia and leucocyte count between the groups. Histological examination showed inflammation at the ablation site at 2 weeks, by 8 weeks this was replaced by scarring. Conclusion: The results of this study suggest that endoscopic perductal electrolytic ablation of the pancreas is feasible and safe. Biochemical and histological findings indicate self-limiting localised inflammation of the pancreas. This technique may have a role in the palliation of pancreatic cancer and warrants further investigation.

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Section: Discussionmentioning

confidence: 99%

Endoscopic Perductal Electrolytic Ablation of the Pancreas: Experimental Studies of Morbidity and Mortality

Morrison¹,

Court²,

Teague³

et al. 2005

Dig Dis

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“…11,13,32,35,36 When pancreatography is completely avoided, PEP should be very uncommon (< 3%). 13,37,38 Reasonable definitions for difficult cannulation range from cannulation attempts for > 5-10 minutes, > 5-15 cannulation attempts, and/or > 1-5 inadvertent pancreatic duct manipulations. 11,29,31 In situations where biliary cannulation is difficult and repeated pancreatic cannulation occurs, some experts advocate a double guidewire technique (DGWT) to increase success.…”

Section: Procedures Factorsmentioning

confidence: 99%

Endoscopic retrograde cholangiopancreatography complications: Techniques to reduce risk and management strategies

Tarnasky

Kedia

2017

Int J Gastrointest Interv

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Adverse events after endoscopic retrograde cholangiopancreatography (ERCP) are not uncommon and can be associated with tragic outcomes. Bleeding, perforation, and post-ERCP pancreatitis are the most common complications. Some events are unavoidable; others are associated with well described risk factors so that they can be either anticipated and/or measures can be taken for prevention or at least risk reduction. This review will focus on the more common complications after ERCP, their risk factors, and potential strategies for risk reduction. Additionally, recommendations for management of ERCP complications will be presented.

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“…In general, post- ERCP pancreatitis and hyperamylasemia occur in 1.8-7.2 [1,2,3,4] and 60-70% of patients [5,6], respectively. Mann et al [7] reported that hyperamylasemia was related to the development of acute pancreatitis through neutrophil activation; therefore, a reduction in amylase levels is necessary to prevent post-ERCP pancreatitis.…”

Section: Introductionmentioning

confidence: 99%

Direct Spraying of Shakuyakukanzoto onto the Duodenal Papilla: A Novel Method for Preventing Pancreatitis following Endoscopic Retrograde Cholangiopancreatography

et al. 2015

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Background/Aims: Topical epinephrine application to the duodenal papilla reduces spasm of the sphincter of Oddi and prevents acute pancreatitis following endoscopic retrograde cholangiopancreatography (ERCP). Shakuyakukanzoto (TJ-68) has an inhibitory effect on muscle contraction. Therefore, TJ-68 potentially allows the relaxation of the sphincter of Oddi, which can aid in the prevention of post-ERCP pancreatitis. Methods: Thirty-six patients planned for ERCP were divided into TJ-68 (n = 17) and control groups (n = 19). In the TJ-68 group, the TJ-68 solution was endoscopically sprayed directly onto the duodenal papilla of patients. To assess the effects of TJ-68, serum amylase levels were measured at 1 h and 1 day after ERCP and symptoms were evaluated. Results: The serum amylase levels at 1 h after ERCP were 273.6 ± 212.0 IU/l in the TJ-68 group and 428.7 ± 281.6 IU/l in the control group, showing a statistically significant difference (p = 0.036). The serum amylase levels at 24 h after ERCP were 230.0 ± 182.7 IU/l in the TJ-68 group and 497.4 ± 514.0 IU/l in the control group (p = 0.011). Post-ERCP pancreatitis was observed in 0 and 4 patients (21.1%) in the TJ-68 and control groups, respectively, which was not statistically significant (p = 0.11). Conclusion: Direct TJ-68 solution application to the duodenal papilla significantly inhibited the elevation of serum amylase levels. However, the preventive effect regarding post-ERCP pancreatitis was not confirmed in this study.

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Hyperamylasaemia and Acute Pancreatitis Following Endoscopic Retrograde Cholangiopancreatography

Cited by 74 publications

References 0 publications

Endoscopic Perductal Electrolytic Ablation of the Pancreas: Experimental Studies of Morbidity and Mortality

Endoscopic Perductal Electrolytic Ablation of the Pancreas: Experimental Studies of Morbidity and Mortality

Endoscopic retrograde cholangiopancreatography complications: Techniques to reduce risk and management strategies

Direct Spraying of Shakuyakukanzoto onto the Duodenal Papilla: A Novel Method for Preventing Pancreatitis following Endoscopic Retrograde Cholangiopancreatography

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