| Safety of ERCP during pregnancy. | |
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MedLine Citation:
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PMID: 12591046 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: There are few data in the literature regarding the indications, therapy, and safety of endoscopic management of pancreatico-biliary disorders during pregnancy. We report the largest single center experience with ERCP in pregnancy. METHODS: We reviewed 15 patients that underwent ERCP during pregnancy. In all patients, the pelvis was lead-shielded and the fetus was monitored by an obstetrician. Fluoroscopy was minimized and hard copy radiographs taken only when essential. RESULTS: The mean patient age was 28.9 yr (15-36 yr). The mean duration of gestation was 25 wk (12-33 wk); one patient was in the first, five in the second, and nine in the third trimester. The indications were gallstone pancreatitis (n = 6), choledocholithiasis on ultrasound (n = 5), elevated liver enzymes and a dilated bile duct on ultrasound (n = 2), abdominal pain and gallstones (n = 1), and chronic pancreatitis (n = 1). ERCP findings were bile duct stones (n = 6), patulous papilla (n = 1), bile duct debris (n = 1), normal bile duct and gallstones or gallbladder sludge (n = 3), dilated bile duct and gallstones (n = 1), normal bile duct and no gallstones (n = 2), and chronic pancreatitis (n = 1). Six patients underwent sphincterotomies and one a biliary stent insertion. One sphincterotomy was complicated by mild pancreatitis. All infants delivered to date have had Apgar-scores >8, and continuing pregnancies are uneventful. Mean fluorosocopy time was 3.2 min (SD +/- 1.8). An estimated fetal radiation exposure was 310 mrad (SD +/- 164) which is substantially below the accepted teratogenic dose. CONCLUSIONS: ERCP in pregnancy seems to be safe for both mother and fetus; however, it should be restricted to therapeutic indications with additional intraprocedure safety measures. |
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Authors:
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T C K Tham; J Vandervoort; R C K Wong; H Montes; A D Roston; A Slivka; A P Ferrari; D R Lichtenstein; J Van Dam; R D Nawfel; R Soetikno; D L Carr-Locke |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The American journal of gastroenterology Volume: 98 ISSN: 0002-9270 ISO Abbreviation: Am. J. Gastroenterol. Publication Date: 2003 Feb |
Date Detail:
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Created Date: 2003-02-19 Completed Date: 2003-04-01 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0421030 Medline TA: Am J Gastroenterol Country: United States |
Other Details:
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Languages: eng Pagination: 308-11 Citation Subset: IM |
Affiliation:
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Division of Gastroenterology, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Biliary Tract Diseases / radiography* Cholangiopancreatography, Endoscopic Retrograde* Female Fetus / radiation effects Gestational Age Humans Pancreatic Diseases / radiography* Pregnancy Pregnancy Complications / radiography* Safety Time Factors |
| Comments/Corrections | |
Comment In:
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Am J Gastroenterol. 2003 Feb;98(2):237-8
[PMID:
12591033
]
Am J Gastroenterol. 2003 Sep;98(9):2100-1 [PMID: 14499796 ] Am J Gastroenterol. 2003 Oct;98(10):2331-2; author reply 2332 [PMID: 14572594 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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