Complications of ERCP

Anderson, Michelle A.; Fisher, Laurel; Jain, Rajeev; Evans, John A.; Appalaneni, Vasundhara; Ben–Menachem, Tamir; Cash, Brooks D.; Decker, G. Anton; Early, Dayna S.; Fanelli, Robert D.; Fisher, Deborah A.; Fukami, Norio; Hwang, Joo Ha; Ikenberry, Steven O.; Jue, Terry L.; Khan, Khalid; Krinsky, Mary Lee; Malpas, Phyllis M.; Maple, John T.; Sharaf, Ravi; Shergill, Amandeep K.; Dominitz, Jason A.

doi:10.1016/j.gie.2011.07.010

Cited by 439 publications

(247 citation statements)

References 93 publications

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“…However, EST has many contraindications, such as number of stones, presence of tortuous ducts, or presence of periampullary duodenal diverticula, and varies depending on institutional and individual techniques and experiences. Especially, EST disturbed the anatomy of the sphincter of Oddi which has been postulated to cause stasis of bile and recurrent stone formation [7]. With the emphasis on the sphincter of Oddi, more and more scholars performed surgery approaches.…”

Section: Discussionmentioning

confidence: 99%

Primary Closure Following Laparoscopic Common Bile Duct Reexploration for the Patients Who Underwent Prior Biliary Operation

et al. 2016

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To assess feasibility of primary closure following laparoscopic common bile duct reexploration for the patients who underwent prior biliary operation, we retrospectively studied 50 patients with recurrent or residual common bile duct (CBD) stones who underwent laparoscopic biliary reoperation between June 2008 and June 2013. Endoscopic sphincterotomy (EST) was treated for all these patients and validated failed. They were divided into two groups. Primary closure following laparoscopic common bile duct exploration (LCBDE) was performed in 25 cases (group A); LCBDE plus T-tube drainage was performed in others (group B). The items of operation were compared. The duration of the operation in group A was shorter than that in group B (141 ± 85 vs 158 ± 71 min, p < 0.05), as was postoperative hospital stay (16 ± 2.3 vs 23 ± 2.3 h, p < 0.05) and the times of postoperative gastrointestinal function recovery (16 ± 2.3 vs 23 ± 2.3 h, p < 0.05). Just one duodenum was damaged in group B. Postoperative clinically significant bile leakage occurred in two patients in group A and one case in group B. The median follow-up was 18 months. No postoperative pancreatitis, postoperative bleeding, bile peritonitis after T-tube removal, stricture of bile duct, and death occurred in the two groups. Just two cases in group B were verified residual stones after 1 month. Primary closure following laparoscopic common bile duct reexploration for the patients who underwent prior biliary operation appears to be a minimally invasive, safe, feasible, and effective procedure when done by expert laparoscopic surgeons.

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Section: Discussionmentioning

confidence: 99%

Primary Closure Following Laparoscopic Common Bile Duct Reexploration for the Patients Who Underwent Prior Biliary Operation

et al. 2016

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“…Endoscopic retrograde cholangiopancreatography (ERCP) is considered as the gold standard for diagnosis and treatment of choledocholithiasis (CL). However, it carries a considerable risk of short-term complications such as post-ERCP pancreatitis, post-endoscopic sphincterotomy bleeding, cholangitis and perforation (6). It has been previously stated that the cost-effectiveness is favorable only when performing ERCP in patients with a high likelihood of CL (7).…”

Section: Introductionmentioning

confidence: 99%

Accuracy of ASGE criteria for the prediction of choledocholithiasis

Rivera¹,

Gonzalez²,

Monreal-Robles³

et al. 2016

Rev Esp Enferm Dig

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Background/aims: Few studies have validated the performance of guidelines for the prediction of choledocholithiasis (CL). Our objective was to prospectively assess the accuracy of the American Society for Gastrointestinal Endoscopy (ASGE) guidelines for the identification of CL.Methods: A two-year prospective evaluation of patients with suspected CL was performed. We evaluated the ASGE guidelines and its component variables in predicting CL.Results: A total of 256 patients with suspected CL were analyzed. Of the 208 patients with high-probability criteria for CL, 124 (59.6%) were found to have a stone/sludge at endoscopic retrograde cholangiopancreatography (ERCP). Among 48 patients with intermediate-probability criteria, 21 (43.8%) had a stone/ sludge. The performance of ASGE high-and intermediate-probability criteria in our population had an accuracy of 59.0% (85.5% sensitivity, 24.3% specificity) and 41.0% (14.4% sensitivity, 75.6% specificity), respectively. The mean ERCP delay time was 6.1 days in the CL group and 6.4 days in the group without CL, p = 0.638. The presence of a common bile duct (CBD) > 6 mm (OR 2.21; 95% CI, 1.20-4.10), ascending cholangitis (OR 2.37; 95% CI, 1.01-5.55) and a CBD stone visualized on transabdominal US (OR 3.33; 95% CI, 1.48-7.52) were stronger predictors of CL. The occurrence of biliary pancreatitis was a strong protective factor for the presence of a retained CBD stone (OR 0.30; 95% CI,.Conclusions: Irrespective of a patient's ASGE probability for CL, the application of current guidelines in our population led to unnecessary performance of ERCPs in nearly half of cases.

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“…De Lédinghen et al [39] reported a 100% negative predictive value of EUS in the diagnosis of lithiasis, thus excluding the needing for further investigation and limiting unnecessary surgery. In the previously mentioned study by Scheiman et al [32] , EUS was the most useful test for confirming a normal biliary tree, and the initial EUS strategy had the greatest cost-utility by avoiding unnecessary ERCPs and preventing ERCP-related complications [40] . In 2001, a prospective study performed by Kim et al [41] showed the existence of pathological conditions in subjects with dilatated CBD, despite the lack of symptoms, jaundice or causative lesions in TUS.…”

Section: Impact Of Eus In the Diagnostic Work Up Of Cbd Dilatationmentioning

confidence: 95%

Endoscopic ultrasound in common bile duct dilatation with normal liver enzymes

Angelis¹,

Marietti²,

Bruno³

et al. 2015

WJGE

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In recent years, the description of isolated bile duct dilatation has been increasingly observed in subjects with normal liver function tests and nonspecific abdominal symptoms, probably due to the widespread use of high-resolution imaging techniques. However, there is scant literature about the evolution of this condition and the impact of endoscopic ultrasound (EUS) in the diagnostic work up. When noninvasive imaging tests (transabdominal ultrasound, computed tomography or magnetic resonance cholangiopancreatography) fail to identify the cause of dilatation and clinical or biochemical alarm signs are absent, the probability of having biliary disease is considered low. In this setting, using EUS, the presence of pathologic findings (choledocholithiasis, strictures, chronic pancreatitis, ampullary or pancreatic tumors, cholangiocarcinoma), not always with a benign course, has been observed. The aim of this review has been to evaluate the prevalence of disease among nonjaundiced patients without signs of cytolysis and/or cholestasis and the assessment of EUS yield. Data point out to a promising role of EUS in the identification of a potential biliary pathology. EUS is a low invasive technique, with high accuracy, that could play a double cost-effective role: identifying pathologic conditions with dismal prognosis, in asymptomatic patients with negative prior imaging tests, and excluding pathologic conditions and further follow-up in healthy subjects. Core tip: Common bile duct dilatation, often without identified causes, in subjects with normal liver function tests and nonspecific abdominal symptoms, and absence of lesions on prior noninvasive imaging tests, is increasingly found in the clinical practice. Since the clinical suspicion for biliary pathology in that setting is usually low, and there are limited literature data, this condition is ignored. However, recent evidences show the existence of pathologies among these patients, often with a non-benign course. In this scenario, endoscopic

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Complications of ERCP

Cited by 439 publications

References 93 publications

Primary Closure Following Laparoscopic Common Bile Duct Reexploration for the Patients Who Underwent Prior Biliary Operation

Primary Closure Following Laparoscopic Common Bile Duct Reexploration for the Patients Who Underwent Prior Biliary Operation

Accuracy of ASGE criteria for the prediction of choledocholithiasis

Endoscopic ultrasound in common bile duct dilatation with normal liver enzymes

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