China
Africa
Explore chapters and articles related to this topic
Liver, Biliary Tract and Pancreatic Disease
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Endoscopic retrograde cholangiopancreatography (ERCP) allows both visualization and therapeutic intervention of the biliary or pancreatic ducts after they have been cannulated using an endoscopic duodenoscope and injected with contrast (Figure 9.5). It allows biopsy or cytology of the pancreatic ampulla and some bile duct lesions. Diagnostic ERCP is being replaced by magnetic resonance cholangiopancreatography (MRCP).
An overweight patient with epigastric pain
Published in Tim French, Terry Wardle, The Problem-Based Learning Workbook, 2022
Endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy and gallstone removal may be needed if the patient shows progressive jaundice (within the first 24 hours).
Cystic Fibrosis and Pancreatic Disease
Published in Praveen S. Goday, Cassandra L. S. Walia, Pediatric Nutrition for Dietitians, 2022
Elissa M. Downs, Jillian K. Mai, Sarah Jane Schwarzenberg
Surgical interventions may be required during an acute episode to address biliary disease. This may include an endoscopic retrograde cholangiopancreatography (ERCP), if obstructive jaundice or cholangitis, and/or a cholecystectomy for non-obstructing gallstones.
Meta-analysis comparing the efficiency of high-flow nasal cannula versus low-flow nasal cannula in patients undergoing endoscopic retrograde cholangiopancreatography
Published in Baylor University Medical Center Proceedings, 2022
Mohamed Gamal, Manar Ahmed Kamal, Mohamed Abuelazm, Amman Yousaf, Basel Abdelazeem
Endoscopic retrograde cholangiopancreatography (ERCP) is a common intervention to diagnose and treat pancreatic and biliary pathologies.1 The procedure is primarily performed in the lateral or prone position under moderate to deep sedation or general anesthesia. However, performing ERCP under sedation in the prone position increases the risk of hypoxemia, leading to procedural interruptions or even termination.2–4 Conventionally, a low-flow nasal cannula (LFNC) is used to reduce hypoxemia events during anesthesia from 77% to 16%.5,6 However, the maximum oxygen flow through the nasal cannula is 5 L/min, with a fraction of inspired oxygen of not greater than 0.5. A high-flow nasal cannula (HFNC) can deliver heated and humidified gas under physiological temperature in a high flow rate up to 70 L/min fraction of inspired oxygen of 100%.7 This can generate positive pressure in the upper airways, increasing end-expiratory lung capacity and improving oxygenation.8,9 Therefore, we conducted a systematic review and meta-analysis to assess the effectiveness of HFNC compared to LFNC in preventing hypoxemic events in patients undergoing ERCP.
Covered self-expandable metallic stent versus plastic stent for preoperative endoscopic biliary drainage in patients with pancreatic cancer: a multi-center retrospective cohort study
Published in Scandinavian Journal of Gastroenterology, 2022
Hironao Ichikawa, Takuji Iwashita, Yuhei Iwasa, Shinya Uemura, Ryuichi Tezuka, Mitsuru Okuno, Tsuyoshi Mukai, Kensaku Yoshida, Akinori Maruta, Keisuke Iwata, Katsutoshi Murase, Shinji Osada, Masahiko Kawai, Ichiro Yasuda, Masahito Shimizu
All endoscopic procedures were performed using a standard duodenoscope (TJF-260V, JF-260V, or JF-240; Olympus, Tokyo, Japan). Antibiotics were prophylactically administered before and after the endoscopic procedure. Endoscopic retrograde cholangiopancreatography (ERCP) was performed under conscious sedation. After biliary cannulation, a cholangiogram was performed, followed by guidewire placement through the obstruction. An additional cholangiogram was obtained to determine the location and length of the obstruction. A stent with a sufficient length covering the obstruction and duodenal papilla was chosen for biliary drainage. Endoscopic sphincterotomy or two-step drainage using nasobiliary drainage (NBD) was performed according to the operator’s decision. Then, a fully covered SEMS (CSEMS, 8–12-mm diameter with 5–8-cm length) or PS (8–8.5 Fr with 5–10-cm length) was deployed at the obstruction site (Figure 1). After proper biliary drainage with improved liver function test, NAC was performed in some patients and the regimens were S-1, gemcitabine plus S-1, gemcitabine plus nab-paclitaxel, or FOLFIRINOX.
Endoscopic management of pancreaticopleural fistula after recurrent acute pancreatitis
Published in Baylor University Medical Center Proceedings, 2021
Abinash Subedi, Dragos Manta, Amrendra Mandal, Aakritee Sharma Subedi, Nuri Ozden
CT of the abdomen with contrast showed mild pancreatic fat stranding at the tail of the pancreas without any evidence of pancreatic pseudocysts. Endoscopic retrograde cholangiopancreatography (ERCP) revealed extravasation of contrast from the tail of the pancreas coursing toward the right hemidiaphragm, suggesting a fistula in communication with the pleural space (Figure 1b). Pancreatic sphincterotomy was performed, and a 4 Fr by 9 cm plastic straight pancreatic duct stent was placed in the main pancreatic duct (Figure 1c). The patient was discharged with a pigtail draining catheter on his right chest. The chest tube was withdrawn after 3 weeks once CT of the chest confirmed resolution of the pleural effusion. He was asymptomatic at 2-month follow-up, and imaging revealed no further development of pleural effusion (Figure 1d).