| Safety and efficacy of pancreatic sphincterotomy in chronic pancreatitis. | |
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MedLine Citation:
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PMID: 9744598 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Endoscopic pancreatic sphincterotomy (EPS) is being performed with increasing frequency as a prerequisite to interventional measures in the pancreatic duct. The aim of this study was to evaluate EPS with regard to technique, success, complications, and mortality in patients with chronic pancreatitis. METHODS: Between January 1989 and September 1996, the results of all consecutive EPSs in patients with chronic pancreatitis were documented in a standardized form. Patients were followed by clinical investigation and blood sample analysis at 4, 24, and 48 hours after EPS. Complications were classified according to commonly accepted criteria. RESULTS: EPS was performed in 118 patients with chronic pancreatitis (men 75%, women 25%, 48+/-10 years). Ninety-four patients (80%) underwent guidewire-assisted EPS, and 24 patients (20%) underwent needle-knife EPS. Seventy-seven EPS procedures (65%) were primarily successful (guidewire EPS: 60 of 94, 64%; needle-knife EPS: 17 of 24, 71%). Additional endoscopic cutting techniques (needle-knife papillotomy, biliary endoscopic sphincterotomy) were required in 41 patients (35%). In total, EPS was successful in 116 patients (98%). The complication rate was 4.2% (4 cases of moderate pancreatitis, 1 severe bleeding, no deaths). All complications were managed nonoperatively. CONCLUSIONS: In patients with chronic pancreatitis, EPS with a standard sphincterotome or with a needle-knife offers an effective and reliable approach to the pancreatic duct system. Additional cutting techniques may be necessary in approximately one third of cases before an EPS can be successfully performed. The complication rate of EPS in patients with chronic pancreatitis appears to be lower than the complication rate of biliary sphincterotomy for other indications. |
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Authors:
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C Ell; T Rabenstein; H T Schneider; T Ruppert; M Nicklas; D Bulling |
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Publication Detail:
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Type: Clinical Trial; Journal Article |
Journal Detail:
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Title: Gastrointestinal endoscopy Volume: 48 ISSN: 0016-5107 ISO Abbreviation: Gastrointest. Endosc. Publication Date: 1998 Sep |
Date Detail:
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Created Date: 1998-12-10 Completed Date: 1998-12-10 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0010505 Medline TA: Gastrointest Endosc Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 244-9 Citation Subset: IM |
Affiliation:
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Department of Medicine I, University of Erlangen-Nuremberg, Erlangen, Germany. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Chronic Disease Female Follow-Up Studies Humans Male Middle Aged Pancreatitis / surgery* Prospective Studies Retrospective Studies Sphincterotomy, Endoscopic / adverse effects, methods* Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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