Post-ERCP Pancreatitis and Hyperamylasemia: Patient-Related and Operative Risk Factors

Christoforidis, E.; Goulimaris, I.; Kanellos, Ioannis; Tsalis, Konstantinos; Demetriades, Constantinos; Betsis, D.

doi:10.1055/s-2002-23630

Cited by 136 publications

(102 citation statements)

References 16 publications

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“…Pancreatitis is the most common complication of endoscopic retrograde cholangiopancreatography (ERCP), with a reported incidence of 1%-10% in most prospective studies [1][2][3][4][5][6][7][8][9] . The generally accepted criteria for the diagnosis of post-ERCP pancreatitis were proposed in 1991 during a consensus workshop.…”

Section: Introductionmentioning

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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Section: Introductionmentioning

confidence: 99%

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

Senol¹,

Sarıtaş²,

Demirkan³

2009

WJG

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“…This is in contrast to the well-known complications of ERCP. Published incidences of post-ERCP pancreatitis range from 1.8% to 6.7%, with an overall morbidity rate of 5% to 19% (1)(2)(3)(4)(5). Certainly, complications are of particular concern in this group of patients, many of whom presented with acute pancreatitis.…”

Section: Discussionmentioning

confidence: 99%

“…ERCP involves endoscopic cannulation of the common bile duct with a side-viewing endoscope and a retrograde contrast injection. ERCP carries an associated 0.1% to 1.3% mortality rate and 5% to 19% morbidity rate (1-3), including a reported 1.8% to 6.7% incidence of pancreatitis (1,(3)(4)(5). Furthermore, of all ERCPs done for suspected CDL, 27% to 66% result in a normal examination with no stones identified (2,(6)(7)(8)(9)(10)(11)(12)(13).…”

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confidence: 99%

Usefulness of Endoscopic Ultrasound in Patients at High Risk of Choledocholithiasis

Dittrick

Lamont²,

Kuhn³

et al. 2005

Baylor University Medical Center Proceedings

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Background: Endoscopic retrograde cholangiopancreatography (ERCP) has been considered the nonsurgical gold standard for the diagnosis and treatment of choledocholithiasis (CDL). Complications include a 0.1% to 1.3% mortality rate and a 5% to 19% morbidity rate, including a reported 1.8% to 6.7% incidence of postprocedure pancreatitis. Twenty-seven percent to 67% of ERCPs done for suspected choledocholithiasis ultimately have negative results. Endoscopic ultrasound (EUS) has been proposed as an alternate means of diagnosing choledocholithiasis that may eliminate the need for ERCP and its associated morbidities in certain patients. Methods: Retrospective chart review identified 30 patients who underwent EUS with or without ERCP for suspected choledocholithiasis. Reports of all procedures performed were obtained and data were collected on all biliary abnormalities identified on both EUS and ERCP. Results: Pancreaticobiliary abnormalities were identified in 27 of 30 pa-

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“…Number of pancreatic injections and the extent to which the pancreatic duct is filled is associated with PEP. 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.…”

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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Post-ERCP Pancreatitis and Hyperamylasemia: Patient-Related and Operative Risk Factors

Cited by 136 publications

References 16 publications

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

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

Usefulness of Endoscopic Ultrasound in Patients at High Risk of Choledocholithiasis

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

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