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Gastrointestinal system
Published in David A Lisle, Imaging for Students, 2012
Non-surgical management of bile duct stones is normally done via ERCP, with widening of the lower end of the common bile duct (sphincterotomy) and removal of stones via a small wire basket. Occasionally, bile duct stones may be removed via a T-tube tract. This may be done via basket removal or flexible choledochoscope. The T-tube should be in situ for at least 4 weeks postsurgery to ensure a ‘mature’ tract able to accept wires and catheters. Complications are rare and may include pancreatitis, cholangitis and bile leak.
Bioburden and transmission of pathogenic bacteria through elevator channel during endoscopic retrograde cholangiopancreatography: application of multiple-locus variable-number tandem-repeat analysis for characterization of clonal strains
Published in Expert Review of Medical Devices, 2019
Masoumeh Azimirad, Masoud Alebouyeh, Amir Sadeghi, Elham Khodamoradi, Hamid Asadzadeh Aghdaei, Amir Houshang Mohammad Alizadeh, Mohammad Reza Zali
Although post-ERCP infection is a risk factor for cholangitis and bacteremia, it was shown that administration of cephalosporins, aminoglycosides, and fluoroquinolones for antibiotic prophylaxis, especially in patients with underlying diseases, can prevent these complications successfully. Resistance phenotype of responsible agents to common antibiotics used for prophylaxis is clinically more important, which can lead to life-threatening diseases like sepsis and pancreatic necrosis [29]. In our study, among the P. aeruginosa isolates, MDR phenotype was found in >42% of the samples. Resistance to the prophylactic antibiotics was observed among most of the strains, which proposed ineffectiveness of them for usage as prophylactic medication regimen. Administration of piperacillin-tazobactam that showed the greatest growth inhibition among our isolates, and other antibiotic combinations, such as amoxicillin-clavulanic acid, seems to be more appropriate to combat the MDR strains.