25 Years of Endoscopic Sphincterotomy in Erlangen: Assessment of the Experience in 3498 Patients

Rabenstein, Thomas; Schneider, H. T.; Hahn, Eckhart G.; C, Ell

doi:10.1055/s-2007-1001439

Cited by 61 publications

(48 citation statements)

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“…The overall complication rate of 9.3% in our trial matches with those in various international trials varying between 5.1% and 15.7% (Table 5) [3,6,8,[12][13][14][15][16][17]. The heterogeneity in reported rates of complications most likely reflects differences in patients` characteristics, endoscopists` skills and experience, and procedural complexity.…”

Section: Discussionsupporting

confidence: 78%

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Quality assurance of sphincterotomy: A prospective single-centre survey

et al. 2011

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AbstractQuality assurance becomes an increasingly important part of clinical medicine and of the field of endoscopy. Endoscopic sphincterotomy is associated with a fairly high complication rate. We aimed to assess our quality of sphincterotomy for benchmarking by using a prospective electronic database registry, and to identify potential risk factors for post-interventional complications. Over 2 years, 471 sphincterotomies were performed in a single tertiary referral centre. Patient- and procedure-related variables were prospectively recorded with the support of a multi-centre international sphincterotomy registry. Multivariate analysis was performed. The overall post-interventional complication rate was 9.3%. Pancreatitis happened in 5.5%, bleeding in 2.1%, perforation in 1.3%, and cholangitis in 0.4%. In the multivariate analysis following variables remained highly significant and predictive for complications: ‘papilla only in lateral view’ (p=0.001), antiplatelet therapy (p=0.024), and opacification with contrast up to the pancreatic tail (p=0.001). The primary success rate of sphincterotomy was 95.1%. The rate of post-interventional pancreatitis did not differ significantly regardless of the presence of prophylactic pancreatic stent (p=0.56). The outcome of sphincterotomy in our centre matches with literature data. The extent of pancreatic duct opacification has an influence on the pancreatitis rate. Prevention of pancreatitis by inserting pancreatic stents is not confirmed.

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Section: Discussionsupporting

confidence: 78%

“…Thus the results -even if significant -should be confirmed in larger surveys. The protective effect of low-dose anticoagulation against post-interventional pancreatitis suggested by Rabenstein et al [16] could not be confirmed, but there were only few data of patients who received heparin.…”

Section: Discussionmentioning

confidence: 90%

Quality assurance of sphincterotomy: A prospective single-centre survey

et al. 2011

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“…156 Finally, surgery would exist as a last alternative for uncontrollable life-threatening bleed, although its use has decreased in the past two decades. 169 …”

Section: Managementmentioning

confidence: 99%

Endoscopic retrograde cholangiopancreatography complications: Techniques to reduce risk and management strategies

Tarnasky

Kedia

2017

Int J Gastrointest Interv

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Adverse events after endoscopic retrograde cholangiopancreatography (ERCP) are not uncommon and can be associated with tragic outcomes. Bleeding, perforation, and post-ERCP pancreatitis are the most common complications. Some events are unavoidable; others are associated with well described risk factors so that they can be either anticipated and/or measures can be taken for prevention or at least risk reduction. This review will focus on the more common complications after ERCP, their risk factors, and potential strategies for risk reduction. Additionally, recommendations for management of ERCP complications will be presented.

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“…Delayed or clinically significant hemorrhage is an increasingly rare complication of sphincterotomy which can occur up to a week or more after the procedure. Data from older large multicenter studies suggest that significant hemorrhage was typically seen in 1-2 % of cases postsphincterotomy [1,[34][35][36].…”

Section: Bleeding What Are the Risk Factors And How Should They Be Mamentioning

confidence: 99%