Pancreatic Sphincter Hypertension Increases the Risk of Post-ERCP Pancreatitis

Tarnasky, PR; Cunningham, John M.; Cotton, Peter B.; Hoffman, Brenda J.; Palesch, Yuko Y.; Freeman, Janice; Curry, Nancy S.; Hawes, Robert H.

doi:10.1055/s-2007-1004185

Cited by 100 publications

(44 citation statements)

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“…Acute pancreatitis is a well-recognized complication of endoscopic retrograde cholangiopancreatography, but it is not considered to be a complication associated with other endoscopic procedures [14,15]. The present study adds to the growing body of evidence that both post-procedure small elevations of pancreatic enzymes or the development of frank pancreatitis are frequently encountered complications after peroral DBE.…”

Section: Discussionmentioning

confidence: 74%

Post-procedure Elevated Amylase and Lipase Levels After Double-Balloon Enteroscopy: Relations with the Double-Balloon Technique

et al. 2009

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Section: Discussionmentioning

confidence: 74%

Post-procedure Elevated Amylase and Lipase Levels After Double-Balloon Enteroscopy: Relations with the Double-Balloon Technique

et al. 2009

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“…SOM is also associated with an incidence of 9%-33% for post-procedure pancreatitis. 29 SOD may involve either predominantly biliary sphincter or pancreatic sphincter or both. Pancreatic SOD is more likely to be associated with IRAP.…”

Section: Sod (%)mentioning

confidence: 99%

Recurrent acute pancreatitis: an approach to diagnosis and management

Kedia¹,

Dhingra²,

Garg³

2013

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Recurrent acute pancreatitis (RAP) is defined as more than two attacks of acute pancreatitis (AP) without any evidence of underlying chronic pancreatitis (CP). As the known causes of AP are generally taken care of, RAP usually occurs in the idiopathic group, which forms 20%- In general, empirical cholecystectomy should be discouraged with the availability and widespread use of EUS. Endoscopic sphincterotomy is advised if there is strong suspicion of SOD. Minor papilla sphincterotomy should be carried out in those with PD but with limited expectations. Regular follow-up of patients with IRAP is necessary because most patients are likely to develop CP in due course.

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“…Diclofenac, an NSAID, inhibits phospholipase A 2 , which is thought to play a critical role in the early inflammatory cascade. In addition, it strongly inhibits neutrophil/endothelial attachment, thus preventing accumulation of neutrophils at the site of tissue damage [46] , and inhibits the expression of nitric oxide synthase, an enzyme associated with inflammation and cell damage [47] . It is a cheap, widely available agent with a short, easy method of administration.…”

Section: Table 3 Serum Amylase Level (Mean ± Se Iu/l) Following Ercpmentioning

confidence: 99%

Efficacy of intramuscular diclofenac and fluid replacement in prevention of post-ERCP pancreatitis

Senol¹,

Sarıtaş²,

Demirkan³

2009

WJG

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AIM:To assess the efficacy of intramuscular diclofenac and fluid replacement for prevention of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis. METHODS:A prospective, placebo-controlled study was conducted in 80 patients who underwent ERCP. Patients were randomized to receive parenteral diclofenac at a loading dose of 75 mg followed by the infusion of 5-10 mL/kg per hour isotonic saline over 4 h after the procedure, or the infusion of 500 mL isotonic saline as placebo. Patients were evaluated clinically, and serum amylase levels were measured 4, 8 and 24 h after the procedure. RESULTS:The two groups were matched for age, sex, underlying disease, ERCP findings, and type of treatment. The overall incidence of pancreatitis was 7.5% in the diclofenac group and 17.5% in the placebo group (12.5% in total). There were no significant differences in the incidence of pancreatitis and other variables between the two groups. In the subgroup analysis, the frequency of pancreatitis in the patients without sphincter of Oddi dysfunction (SOD) was significantly lower in the diclofenac group than in the control group (P = 0.047).CONCLUSION: Intramuscular diclofenac and fluid replacement lowered the rate of pancreatitis in patients without SOD.

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Pancreatic Sphincter Hypertension Increases the Risk of Post-ERCP Pancreatitis

Abstract: Pancreatic sphincter hypertension greatly increases the risk of post-ERCP pancreatitis in patients undergoing treatment or evaluation, or both, for sphincter of Oddi dysfunction.

Cited by 100 publications

References 0 publications

Post-procedure Elevated Amylase and Lipase Levels After Double-Balloon Enteroscopy: Relations with the Double-Balloon Technique

Post-procedure Elevated Amylase and Lipase Levels After Double-Balloon Enteroscopy: Relations with the Double-Balloon Technique

Recurrent acute pancreatitis: an approach to diagnosis and management

Efficacy of intramuscular diclofenac and fluid replacement in prevention of post-ERCP pancreatitis

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