Abstract:
BACKGROUND:Increasingly, pancreatic stents are being placed to prevent post-ERCP pancreatitis. However, guidewire and stent placement may fail if the duct is small or tortuous, potentially exacerbating the risk. This study assessed the impact of unsuccessful pancreatic stent placement on complications and the efficacy of a modified technique for stent insertion when pancreatic ductal anatomy makes stent insertion technically difficult. METHODS:Technical variables and 30-day complications of consecutive therapeutic ERCPs, including attempted major papilla pancreatic stent insertion were prospectively studied. Success rates for pancreatic stent placement were compared for a 1-year period during which conventional deep guidewire insertion was used and another 1-year period in which a modified technique was used as needed in patients with ductal anatomy that made stent placement technically difficult. In the modified technique, a short (2-3 cm) small diameter (3F-5F) stent was placed over a 0.018-in nitinol-tipped guidewire, passed as little as 1 to 2 cm beyond the pancreatic sphincter. RESULTS:In 225 high-risk therapeutic ERCPs, pancreatitis occurred after the procedure in two of 3 (66.7%) patients in whom pancreatic stent insertion failed vs. 32 of 222 (14.4%) patients with successful insertion (p=0.06). Severe pancreatitis occurred only after unsuccessful stent insertion. Significant multivariate risk factors for post-ERCP pancreatitis were unsuccessful pancreatic stent insertion (odds ratio 16.1: 95% CI[1.3, 200]), sphincter of Oddi dysfunction (odds ratio 3.2: 95% CI[1.4, 7.5]), and prior post-ERCP pancreatitis (odds ratio 3.2: 95% CI[1.4, 7.1]). The following were not risk factors: performance of pancreatic, biliary, or needle-knife pre-cut sphincterotomy; number of pancreatic contrast injections; and difficult cannulation. Stent placement was unsuccessful in 3 (3.2%) of 93 attempts during the 1-year period in which a conventional technique was used vs. none of 132 attempts in a subsequent year in which the modified technique was used. CONCLUSIONS:Failed attempts at pancreatic stent placement are associated with an extremely high risk of post-ERCP pancreatitis. Success can be consistently achieved by use of a modified technique.
journal_name
Gastrointest Endoscjournal_title
Gastrointestinal endoscopyauthors
Freeman ML,Overby C,Qi Ddoi
10.1016/s0016-5107(03)02530-6keywords:
subject
Has Abstractpub_date
2004-01-01 00:00:00pages
8-14issue
1eissn
0016-5107issn
1097-6779pii
S0016-5107(03)02530-6journal_volume
59pub_type
杂志文章abstract:BACKGROUND:The aim of this study was to identify predictors of outcome for pancreatic duct (PD) disruption managed by endoscopic transpapillary stent insertion. METHODS:An endoscopy database was used to identify patients with PD disruption, defined as extravasation of contrast from the PD during ERCP. Data collected i...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(04)02832-9
更新日期:2005-04-01 00:00:00
abstract:BACKGROUND:The significance of the small distal tubular adenoma detected by sigmoidoscopy as a predictor of proximal neoplasm remains controversial. The aim of this study was to examine the prevalence of proximal neoplasms in patients with and without distal neoplasms. METHODS:This is a retrospective study of 3131 asy...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1067/mge.2000.107908
更新日期:2000-09-01 00:00:00
abstract:BACKGROUND:EMR for the treatment of duodenal adenomas is challenging due to a thin wall and rich vascularity. OBJECTIVE:To evaluate a novel technique of "underwater" EMR without prior submucosal injection for the removal of large (≥2 cm) laterally spreading nonampullary duodenal adenomas. DESIGN:Prospective, observat...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2013.03.1330
更新日期:2013-09-01 00:00:00
abstract:BACKGROUND AND AIMS:The role of electroacupuncture (EA) in reducing sedative and analgesic requirements during EUS is uncertain. The aim of this study was to investigate the efficacy of EA in reducing procedure-related pain and discomfort during EUS. METHODS:This was a double-blinded randomized controlled study conduc...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.gie.2017.07.029
更新日期:2018-02-01 00:00:00
abstract:BACKGROUND AND AIMS:The effects of chemotherapeutic agents on the development of colorectal adenomas in patients with previous colorectal cancer (CRC) are not defined. Therefore, we evaluated the potential effect of adjuvant chemotherapy on the incidence of colorectal adenomas in patients with previous CRC. METHODS:We...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
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更新日期:2018-03-01 00:00:00
abstract:BACKGROUND:Direct peroral cholangioscopy (POC) by using an ultra-slim endoscope provides direct visualization of the bile duct and allows for therapeutic intervention. Holmium laser lithotripsy can be effective for retained bile duct stones, but it requires direct visualization during the procedure for safe and effecti...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
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更新日期:2011-11-01 00:00:00
abstract:BACKGROUND:Esophageal metastasis of hepatocellular carcinoma (HCC) is extremely rare; it was not serially followed-up by endoscopy. OBJECTIVE:Our purpose was to report the endoscopic findings according to the progression of esophageal metastatic HCC. DESIGN:Case report. RESULTS:In the review of the cases, submucosal...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,评审
doi:10.1016/j.gie.2008.02.043
更新日期:2008-07-01 00:00:00
abstract:BACKGROUND AND AIMS:We developed a suturing method with string and clips for a single-channel endoscope. The feasibility of the string clip suturing method is evaluated in this prospective pilot study. METHODS:This study involved 10 consecutive patients who underwent endoscopic submucosal dissection (ESD) for a duoden...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
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更新日期:2018-04-01 00:00:00
abstract:BACKGROUND:EUS-guided FNA has been well documented to aid in the diagnosis of subepithelial lesions by providing cytologic material. Studies to date evaluating the sensitivity of EUS-FNA for the diagnosis of GI stromal cell tumors (GIST) have been small, and few have relied on surgical histologic diagnosis as the refer...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2008.11.038
更新日期:2009-08-01 00:00:00
abstract:BACKGROUND:Photodynamic therapy appears to be effective in ablating high-grade dysplasia in Barrett's esophagus. Our aim was to identify the most effective and cost-effective strategy for managing high-grade dysplasia in Barrett's esophagus without associated endoscopically visible abnormalities. METHODS:By using deci...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(04)02167-4
更新日期:2004-11-01 00:00:00
abstract:BACKGROUND:Celiac disease may be complicated by symptoms that raise the suspicion of small-intestinal malignancy. The objective is to evaluate wireless capsule endoscopy (WCE) in complicated celiac disease. METHODS:This is a prospective study at a university referral center. There were 47 patients. The indications for...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(05)01566-x
更新日期:2005-07-01 00:00:00
abstract:BACKGROUND:Adenomatous colonic polyps are accepted as premalignant lesions. There is controversy regarding the significance of the hyperplastic polyp. The aim of this study was to determine the incidence of further polyps in patients with only hyperplastic polyps on a first colonoscopy in comparison with patients witho...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(97)70058-0
更新日期:1997-08-01 00:00:00
abstract:BACKGROUND:Direct percutaneous endoscopic jejunostomy (DPEJ) placement succeeds in 72% to 86% of attempts. Failure is most often because of inadequate transillumination or gastroduodenal obstruction. Even in failed cases, patients are exposed to the risks of anesthesia, exploratory percutaneous needle punctures, and th...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2005.10.035
更新日期:2006-03-01 00:00:00
abstract::In a retrospective study, 33 achalasia patients were treated with dilation therapy using large diameter mercury bougienage (mean, 56 French) and/or pneumatic balloon dilation. Mean follow-up time was 35 months. Mercury bougienage, performed in 20 patients, was successful in 10 (50%) with no complications. Pneumatic di...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(91)70614-7
更新日期:1991-01-01 00:00:00
abstract::This study determined the optimum laser energy for ablation of colonic mucosal lesions and small sessile polyps in the canine colon. Neodymium (Nd):YAG laser, argon laser, and monopolar electrocautery were applied to exposed canine colonic mucosa for various application times at various power settings. At the minimum ...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(89)72679-1
更新日期:1989-01-01 00:00:00
abstract:BACKGROUND:Eosinophilic esophagitis (EoE) is a chronic inflammatory condition that can be complicated by esophageal strictures requiring endoscopic dilation. Whereas recent data have advanced the notion that dilation can be done effectively with minimal morbidity, issues concerning safety and tolerability remain. OBJE...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2010.09.034
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:Increased demand for screening colonoscopy necessitates improved efficiency in endoscopy units, especially more efficient use of existing resources. The purpose of this study was to assess the efficiency of the endoscopy unit of a large tertiary care teaching hospital. OBJECTIVE:To assess the efficiency of ...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2006.02.047
更新日期:2006-11-01 00:00:00
abstract:BACKGROUND:Detection of hepatic metastases during EUS is an important component of tumor staging. OBJECTIVE:To describe our experience with EUS-guided FNA (EUS-FNA) of solid hepatic masses and derive and validate criteria to help distinguish between benign and malignant hepatic masses. DESIGN:Retrospective study, sur...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2014.10.035
更新日期:2015-05-01 00:00:00
abstract:BACKGROUND:Gastrointestinal graft-versus-host disease after allogeneic hematopoietic cell transplantation presents a range of upper gastrointestinal endoscopic and histologic abnormalities. Recognition of these sometimes subtle abnormalities is critical for directing specific therapy. METHODS:Endoscopic and histologic...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(99)70390-1
更新日期:1999-05-01 00:00:00
abstract:BACKGROUND:Although some cases of collagenous colitis have been induced by lansoprazole (LPZ), the clinicopathologic features of LPZ-associated collagenous colitis have not been elucidated. OBJECTIVE:To elucidate the clinical, endoscopic, and histopathologic features of LPZ-associated collagenous colitis. DESIGN:Retr...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2008.02.013
更新日期:2008-06-01 00:00:00
abstract:BACKGROUND:Silastic rings are used in gastric bypass procedures for the treatment of obesity, but ring slippage may lead to gastric pouch outlet stenosis (GPOS). Conventional management has been ring removal through abdominal surgery. OBJECTIVE:To describe a novel, safe, minimally invasive, endoscopic technique for th...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.gie.2010.01.057
更新日期:2010-07-01 00:00:00
abstract:BACKGROUND:No objective measure of the level of sedation is universally accepted. However, bispectral index monitoring is currently used to objectively measure sedation levels in several clinical settings. This study compares the temporal relationship of bispectral index levels versus the Observer's Assessment of Alert...
journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章
doi:10.1067/mge.2000.107284
更新日期:2000-08-01 00:00:00
abstract:BACKGROUND:Limited information is available regarding the use of EUS-guided fine-needle aspiration (EUS-FNA) in the diagnosis of lymphoproliferative disorders. The aim of this study was to evaluate the yield of this technique in the primary diagnosis of lymphoma. METHODS:The records were reviewed of 38 consecutive pat...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1067/mge.2001.112841
更新日期:2001-04-01 00:00:00
abstract:BACKGROUND:Radiation proctitis is a complication of radiotherapy for malignant pelvic disease. Argon beam coagulation is a new and rapidly evolving technology that permits a "no-touch" electrocoagulation of diseased tissue. METHODS:We analyzed retrospectively the records of 7 patients with prostatic and endometrial ca...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(99)70054-4
更新日期:1999-04-01 00:00:00
abstract:BACKGROUND:Unsedated transnasal upper endoscopy has a diagnostic yield comparable with that of sedated conventional upper endoscopy. The ability of transnasal upper endoscopy to detect Barrett's metaplasia or dysplastic change has not been systematically evaluated. The aim of this study was to assess the feasibility of...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1067/mge.2002.128131
更新日期:2002-10-01 00:00:00
abstract::This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal. ...
journal_title:Gastrointestinal endoscopy
pub_type: 撤回出版物
doi:10.1016/j.gie.2019.06.012
更新日期:2019-06-19 00:00:00
abstract:BACKGROUND:The removal of small colon polyps by cold snare transection without electrocautery effectively eliminates polyps, and anecdotal reports indicate a low risk of bleeding and perforation. Concerns about using cold snaring have centered on the risk of immediate bleeding and the difficulty in retrieving the polyp...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(05)00376-7
更新日期:2005-08-01 00:00:00
abstract:BACKGROUND:Photodynamic therapy of pancreatic cancer by using percutaneously placed light catheters has been reported. The feasibility and safety of EUS-guided photodynamic therapy of the pancreas was studied in a porcine model. METHODS:After injection of porfimer sodium, a 19-gauge needle was inserted into the pancre...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(03)02361-7
更新日期:2004-01-01 00:00:00
abstract::We evaluated the possibility that the addition of methylene blue to the sclerosant would improve the accuracy of intravariceal injections during endoscopic variceal sclerotherapy. Four patients had eight sessions of endoscopic variceal sclerotherapy with a sclerosant containing a combination of 3% sodium tetradecyl an...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(91)70676-7
更新日期:1991-03-01 00:00:00
abstract:BACKGROUND:Comprehensive, population-based data on ERCP use over the last 30 years in North America are lacking. OBJECTIVE:To establish crude and age-adjusted population-based rates of ERCP, evaluate for changing indications for ERCP, and evaluate for interactions between cholecystectomy technique and ERCP use from 19...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2013.08.028
更新日期:2014-04-01 00:00:00