Long Term Outcomes of Endoscopic Therapy for Idiopathic Acute Recurrent Pancreatitis (IARP)

Samavedy, Ramanujan; Schmidt, Steven M.; Fogel, Evan L.; McHenry, Lee; Watkins, James L.; Sherman, Stuart; Lehman, Glen A.; Howard, Thomas J.

doi:10.1016/j.gie.2007.03.563

Cited by 5 publications

(3 citation statements)

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“…Patients met the following indications were performed with ERCP: (i) confirmed or suspected biliogenic pancreatitis, namely with obviously elevated levels of bilirubin, alanine aminotransferase (ALT) and/or alkaline phosphatase (ALP) at admission, and bilipancreatic duct dilatation, obstruction and choleliths, indicated by imaging examinations after excluded for other causes of ARP; and (ii) idiopathic ARP (IARP), namely when the symptoms and signs, laboratory examination results and imaging findings as well as histological evidence if any at present or previous hospitalizations were unable to explain the symptoms and signs of ARP . The patterns of ERCP intervention included endoscopic sphincterotomy (EST), mechanical basket lithotripsy and papillary balloon dilation lithotomy.…”

Section: Methodsmentioning

confidence: 99%

Etiology, clinical features and management of acute recurrent pancreatitis

Deng

Wang

et al. 2014

J of Digest Diseases

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Section: Methodsmentioning

confidence: 99%

Etiology, clinical features and management of acute recurrent pancreatitis

Deng

Wang

et al. 2014

J of Digest Diseases

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“…Multiple studies, the majority having a cohort design, suggest response to biliary sphincterotomy alone and an incremental benefit of dual over biliary sphincterotomy [18,47,[75][76][77][78]. To date, there are two published, randomized clinical trials on this topic.…”

Section: What Is the Relationship Between Sphincter Of Oddi Dysfunctimentioning

confidence: 99%

Idiopathic Acute Pancreatitis and Sphincter of Oddi Dysfunction: Diagnostic and Therapeutic Role of ERCP and Sphincter of Oddi Manometry

Bang

Coté

2015

ERCP and EUS

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A 44-year-old female presents to the office 1 month following an episode of acute pancreatitis (AP). She denies a history of alcohol use and smoking, has no family history of pancreatitis, and takes no medications. At the time of her presentation, serum liver chemistries, calcium, and triglyceride levels were normal; serum lipase was more than three times the upper limit of normal. At the time of admission, a transabdominal ultrasound (US) showed changes of prior cholecystectomy; this had been performed for intermittent abdominal pain and suspected chronic cholecystitis 5 years ago. The common bile duct was poorly visualized but felt to be normal in diameter. During her admission, a contrast-enhanced abdominal computed tomography (CT) revealed peripancreatic stranding consistent with interstitial AP. There was no evidence of chronic pancreatitis or other structural abnormalities.She has fully recovered from this recent episode of AP, but now reports intermittent episodes of transient, mild epigastric pain, each lasting 15-60 min. She is asymptomatic in the office, but concerned for her risk of permanent damage to her pancreas, and fears recurrence of the severe abdominal pain that prompted admission with AP. She is diagnosed with idiopathic AP. What is your diagnostic and therapeutic approach?

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“…Beyond this population, the benefit of endoscopic biliary, pancreatic, or dual sphincterotomies is unproven. Studies evaluating the efficacy of SOD treatment, via surgical sphincteroplasty or endoscopic sphincterotomy, are limited by their small samples sizes, retrospective design, and short-term follow-up [69][70][71][72][73][74]. In addition, study outcomes vary: attenuation of all recurrent episodes, number of AP episodes during follow-up, and pain, to name a few.…”

Section: Biliary Pancreatic or Dual Sphincterotomies For Idiopathicmentioning

confidence: 99%