Pancreatic stents for prophylaxis against post-ERCP pancreatitis: a meta-analysis and systematic review

Choudhary, Abhishek; Bechtold, Matthew L.; Arif, Murtaza; Szary, Nicholas M.; Puli, Srinivas R.; Othman, Mohamed O.; Pais, Wilson P.; Antillon, Mainor R.; Roy, Praveen K.

doi:10.1016/j.gie.2010.10.039

Cited by 261 publications

(192 citation statements)

References 31 publications

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“…Widespectrum early antibiotic treatment in case of high suspicion of infected necrosis or targeted antibiotic therapy when necrosis infection is certified by CT scan guided fine needle aspiration (CT-FNA with antibiogram) has a much more beneficial role than antibiotic prophylaxis (18). The role of prophylactic antibiotic therapy in the prevention of local or systemic septic complications in acute severe pancreatitis is confirmed in the case of invasive procedures such as ERCP with/without papillotomy or other surgical techniques (19,20). Existing comorbidities must be treated intensively (5,11).…”

Section: Discussionmentioning

confidence: 99%

Severe Acute Pancreatitis - Determinant Factors and Current Therapeutic Conduct

Constantinoiu¹,

Cochior²

2018

chr

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RezumatAşa cum a fost considerată de Dieulafoy şi cum a rămas, pe drept cuvânt "marea drama abdominală", pancreatita acută a constituit întotdeauna, rămânând ca atare şi în prezent, o adevărată provocare diagnostică şi terapeutică din cauza variabilităţii sale etiologice, clinice şi biologice, caracterului imprevizibil al evoluţiei şi dificultăţilor de stabilire a tratamentului adecvat fiecărui pacient. În acest context s-au confruntat de-a lungul timpului concepţii diferite, uneori diametral opuse, cu privire la interpretarea cazurilor şi la algoritmul terapeutic adoptat, dovadă stând numărul foarte mare de lucrări consacrate acestui subiect. Înţelegerea mai aprofundată a fiziopatologiei pancreatitei acute odată cu creşterea interesului în clasificarea severităţii pe baza factorilor determinanţi (locali şi generali) reprezintă factori decisivi în preconizarea severităţii şi adoptarea strategiei terapeutice moderne a acestei maladii complexe şi heterogene.Cuvinte cheie: pancreatita acută severă, factori determinanţi, disfuncţie multiplă de organe (MODS), necroză închistată (WONwalled of necrosis), necrozectomie, tehnici chirurgicale hibride Abstract Considered by Dieulafoy as the "great abdominal drama", acute pancreatitis has always been, and still remains, a real diagnostic and therapeutic challenge because of its etiological, clinical and biological variability, the unpredictable evolution and the difficulty of establishing appropriate treatment for each patient. In this context, various, sometimes diametrically opposed, conceptions about the interpretation of the cases and the adopted therapeutic algorithm have been encountered over time, as evidenced by the great number of papers dedicated to this subject. A more thorough understanding of acute pancreatitis pathophysiology, with increasing interest in severity classification based on determinant factors (local and general) are decisive factors in predicting severity and adopting the modern therapeutic strategy of this complex and heterogeneous disease.

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Section: Discussionmentioning

confidence: 99%

Severe Acute Pancreatitis - Determinant Factors and Current Therapeutic Conduct

Constantinoiu¹,

Cochior²

2018

chr

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“…Analyses of prospective trials have suggested benefit from PPS. [98][99][100][101] The number needed to treat to prevent one case of PEP is less than 10. More importantly, the risk of severe PEP is virtually abolished with PPS.…”

Section: Post-ercp Prophylaxismentioning

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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“…This indication is not valid if there are gallstones without cholangitis. 138 ERCP should be considered, in a stable patient with clinical signs of obstruction. To reduce the risk of post-ERCP pancreatitis, pancreatic duct stents 139 and nonsteroidal anti-inflammatory drugs (NSAIDs) given rectally have been found to be useful, especially in patients at high risk of severe pancreatitis.…”

Section: Gallstonesmentioning

confidence: 99%

The management of the patient with acute pancreatitis: from evidence to clinical practice

Cenci

Restuccia

Gnerre³

et al. 2017

Ital J Med

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Acute pancreatitis is an inflammatory disorder of the pancreas characterized by abdominal pain and elevation of pancreatic enzymes in the blood. The pathogenesis is complex and partly unknown and the evolution is often unpredictable. Many efforts have been made to define this disease and its complications and to classify different grades of severity in order to formulate prognostic scores that could guide the physician in choosing the optimal therapeutic setting and procedures. The management of the patient with pancreatitis is not always optimal and differs among internist, gastroenterologist or surgeon. We think that a patient with clinical suspicion of acute pancreatitis is admitted to medical or surgical department depending on the availability of beds and not according to evidence-based medicine. The aim of this monograph is to identify the optimal management of patients with acute pancreatitis admitted to hospital.

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Pancreatic stents for prophylaxis against post-ERCP pancreatitis: a meta-analysis and systematic review

Cited by 261 publications

References 31 publications

Severe Acute Pancreatitis - Determinant Factors and Current Therapeutic Conduct

Severe Acute Pancreatitis - Determinant Factors and Current Therapeutic Conduct

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

The management of the patient with acute pancreatitis: from evidence to clinical practice

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