Use of Nasopancreatic Drainage for Severe Post-endoscopic Retrograde Cholangiopancreatography Pancreatitis: A Case Series

Kawaguchi, Shinya; Kikuyama, Masataka; Satoh, Tatsunori; Terada, Shuzo

doi:10.2169/internalmedicine.0549-17

Cited by 7 publications

(3 citation statements)

References 22 publications

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“…Nevertheless, no severe PEP was observed after NPD placement. Kawaguchi et al reported that NPD placement helps prevent PEP exacerbation [ 32 ]. NPD placement, similar to a pancreatic duct stent, has a preventive effect on acute pancreatitis in patients with suspected pancreatic cancer.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Diagnostic Yield and Safety of Serial Pancreatic Juice Aspiration Cytologic Examination (SPACE) with Different Indications

et al. 2023

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We assessed whether there are differences in the diagnostic yield and safety of serial pancreatic juice aspiration cytologic examination (SPACE) among different indications. We retrospectively analyzed 226 patients who underwent SPACE. They were classified into group A (patients with pancreatic masses, including advanced adenocarcinoma, sclerosing pancreatitis, or autoimmune pancreatitis), group B (suspicious pancreatic carcinoma patients without obvious pancreatic masses, including small pancreatic carcinoma, carcinoma in situ, or benign pancreatic duct stenosis), and group C (intraductal papillary mucinous neoplasm, IPMN). There were 41, 66, and 119 patients, with malignancy diagnosed in 29, 14, and 22 patients, in groups A, B, and C, respectively. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 69%, 100%, 100%, 57%, and 78% in group A; 79%, 98%, 92%, 94%, and 94% in group B; and 27%, 87%, 32%, 84%, and 76% in group C, respectively. PEP was observed in three (7.3%), three (4.5%), and fifteen (13%) patients in group A, B, and C, respectively (p = 0.20). SPACE is useful and safe in patients with suspicious small pancreatic carcinoma. However, it has limited efficacy and might not be recommended in patients with IPMN because of the high frequency of PEP.

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Section: Discussionmentioning

confidence: 99%

Comparison of Diagnostic Yield and Safety of Serial Pancreatic Juice Aspiration Cytologic Examination (SPACE) with Different Indications

et al. 2023

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“…On the other hand, NPD has a lower risk of retrograde gut bacterial infection than stent placement. A previous case series demonstrated that NPD for severe PEP is effective for early pain relief and might attenuate disease progression [15]. There is currently insufficient evidence that pancreatic duct decompression via NPD during the early phase of AP improves the clinical course.…”

Section: Discussionmentioning

confidence: 99%

Nasopancreatic Drainage for 4 Patients during the Early Phase of Acute Pancreatitis

Hirota

Koiwai

Takasu

et al. 2021

Case Rep Gastroenterol

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We encountered 4 patients with acute pancreatitis (AP) of various etiologies and coexisting acute cholangitis who underwent endoscopic biliary stenting (EBS) and nasopancreatic drainage (NPD) via endoscopic retrograde cholangiopancreatography (ERCP) during the early phase of AP. ERCP is performed to treat acute cholangitis even in the context of AP. However, in difficult cases, accidental contrast media injection or guidewire insertion into the pancreatic duct can happen during ERCP for the purpose of EBS. It is concerned that cannulation injury and increased pancreatic duct pressure can exacerbate existing AP. Because pancreatic guidewire-associated techniques were required for all of them due to difficult biliary cannulation, we performed a NPD catheter placement using the pancreatic guidewire to decompress the pancreatic duct to prevent further exacerbating AP. Surprisingly, all patients dramatically improved without systemic or local complications. NPD could be performed without any adverse events and did not worsen the course of AP. Early decompression of a pancreatic duct using NPD may rather improve AP that had already developed. Further prospective research is needed to confirm our observations.

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“…However, although hyperamylasemia is relatively common [ 36 ], the ratio of PEP is not always high, and severe PEP is rare [ 36 , 40 ]. As pancreatic juice drainage using a nasopancreatic drainage tube can be used to treat acute pancreatitis [ 46 ], the incidence of PEP during SPACE is low. Another problem with SPACE is that it impels the patient to stay in the hospital for several days because of the maintenance of the placed nasopancreatic tube, although meals are not restricted.…”

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confidence: 99%

A Novel Diagnostic Imaging Method for the Early Detection of Pancreatic Cancer

Kikuyama

2023

Diagnostics

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Use of Nasopancreatic Drainage for Severe Post-endoscopic Retrograde Cholangiopancreatography Pancreatitis: A Case Series

Cited by 7 publications

References 22 publications

Comparison of Diagnostic Yield and Safety of Serial Pancreatic Juice Aspiration Cytologic Examination (SPACE) with Different Indications

Comparison of Diagnostic Yield and Safety of Serial Pancreatic Juice Aspiration Cytologic Examination (SPACE) with Different Indications

Nasopancreatic Drainage for 4 Patients during the Early Phase of Acute Pancreatitis

A Novel Diagnostic Imaging Method for the Early Detection of Pancreatic Cancer

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