Document Detail


A simple way of avoiding post-ERCP pancreatitis.
MedLine Citation:
PMID:  15173796     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Pancreatitis occurs in up to 30% of patients who undergo ERCP. This study tested the hypothesis that post-ERCP pancreatitis can be avoided by initially accessing the bile duct with a soft-tipped Teflon tracer 0.035-inch guidewire. METHODS: A single endoscopist performed ERCP in 400 consecutive patients with pancreatobiliary disease who were randomized to two groups. In Group A (200 patients), the bile duct was first accessed by insertion of a soft-tipped Teflon tracer (diameter 0.035 inch) guidewire through a 6F, double channel sphincterotome, followed by cannulation, injection of contrast, and sphincterotomy. In Group B (200 patients), the bile duct was opacified by using traditional methods of cannulation. RESULTS: No case of acute pancreatitis was detected in Group A, whereas, 8 cases were observed in Group B (6 mild, one moderate, one severe) (p < 0.01). In 9 patients in Group A vs. 39 in Group B (p < 0.001), the serum amylase rose to more than 5 times the upper normal limit during the 24 hours after the procedure. There was no procedure-related mortality. CONCLUSIONS: Accessing the bile duct with a soft-tipped tracer guidewire prevents post-ERCP pancreatitis.
Authors:
Fausto Lella; Francesco Bagnolo; Elena Colombo; Umberto Bonassi
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Gastrointestinal endoscopy     Volume:  59     ISSN:  0016-5107     ISO Abbreviation:  Gastrointest. Endosc.     Publication Date:  2004 Jun 
Date Detail:
Created Date:  2004-06-02     Completed Date:  2004-09-14     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0010505     Medline TA:  Gastrointest Endosc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  830-4     Citation Subset:  IM    
Affiliation:
Department of Gastroenterology and Gastrointestinal Endoscopy Unit, Policlinico San Marco, Zingonia, Italy.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adult
Aged
Aged, 80 and over
Amylases / blood
Bile Ducts
Catheterization
Cholangiopancreatography, Endoscopic Retrograde / adverse effects*,  instrumentation,  methods*
Contrast Media / administration & dosage
Female
Humans
Male
Middle Aged
Pancreatitis / diagnosis,  etiology,  prevention & control*
Polytetrafluoroethylene
Risk Factors
Sphincterotomy, Endoscopic / adverse effects
Chemical
Reg. No./Substance:
0/Contrast Media; 9002-84-0/Polytetrafluoroethylene; EC 3.2.1.-/Amylases

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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