Same-day discharge after endoscopic biliary sphincterotomy: observations from a prospective multicenter complication study

Freeman, Martin L.; Nelson, Douglas B.; Sherman, Stuart; Haber, Gregory B.; Fennerty, M. Brian; DiSario, James A.; Ryan, Michael E.; Kortan, Paul P.; Dorsher, Paul J.; Shaw, Michael; Herman, Mary E.; Cunningham, J. T.; Moore, Joseph P.; Silverman, William B.; Imperial, Joanne C.; Mackie, Robert D.; Jamidar, Priya A.; Yakshe, Paul N.; Logan, George B.; Pheley, Alfred M.

doi:10.1016/s0016-5107(99)70385-8

Cited by 71 publications

(46 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A prospective multicenter study of ES performed in conjunction with laparoscopic cholecystectomy for 1,494 patients showed a procedure-related morbidity rate of 7.4%, a procedure-related mortality of 0.5%, and a total mortality rate of 2.2% [14]. Therapeutic recommendations for patients with suspected CBD stones should consider these more inclusive morbidity figures.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic transcystic duct common bile duct exploration

2006

View full text Add to dashboard Cite

The modern era of common bile duct (CBD) surgery started with Mirizzi, who introduced intraoperative cholangiography in 1932. Intraoperative choledoscopy had been developed as an adjunctive to intraoperative cholangiography, which helped to detect CBD stones in an additional 10% to 15% of instances that otherwise would have been missed. Findings have shown choledochoscopy to be an important technique for efficient and effective management of CBD stones. Efforts to treat patients with common duct stones in one session and to avoid the potential complications of endoscopic sphincterotomy resulted in several laparoscopic transcystic CBD (LTCBDE) techniques. The techniques of transcystic stone extraction include lavage, trolling with wire baskets or biliary balloon catheters, cystic duct dilation, biliary endoscopy, and stone retrieval with wire baskets under direct vision and antegrade sphincterotomy, lithotripsy, and catheter techniques. The indications for LTCBDE are filling or equivocal defects at cholangiography, stones smaller than 10 mm, fewer than 9 stones, and possible tumor. The contraindications are stones larger than 1 cm, stones proximal to the cystic duct entrance into the CBD, small friable cystic duct, and 10 or more stones. Experience with LTCBDE shows that the approach is applicable in more than 85% of cases, with a success rate of 85% to 95%. It also is shown to be more cost effective than postoperative endoscopic retrograde cholangiopancreatography. Recent developments in LTCBDE have focused mainly on implementation of robotically assisted surgery and new imaging methods such as magnetic resonance cholangiopancreatography with three-dimensional virtual cholangioscopy and three-dimensional ultrasound. Further technological advances will facilitate the application of laparoscopic approaches to the common duct, which should become the primary strategy for the great majority of patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Laparoscopic transcystic duct common bile duct exploration

2006

View full text Add to dashboard Cite

show abstract

“…However, no significant differences were found in surgery associated complications [43,44], length of hospital stay or mortality. Strom et al presented the results of their retrospective study regarding the role of PBD in patients with resectable pancreatic head cáncer [45][46][47][48][49][50][51][52][53]. They conclude that PBD not only has no favorable effect on survival, but percutaneous transhepatic biliary drainage was found to be an independent prognostic factor associated with worse overall survival [54][55][56][57][58][59].…”

Section: Discusionmentioning

confidence: 99%

Preoperative Biliary Drainage of Jaundiced Patients with Pancreatic Head Cancer: A Routine or Selective Strategy

F¹,

Toutouzas²,

Mubaminyi³

et al. 2017

Pancreat Disord Ther

View full text Add to dashboard Cite

to explore the biliary tree and to decrease jaundice preoperatively. Numerous randomized controlled trials have addressed the issue of preoperative biliary drainage and its impact on perioperative and postoperative results [3,4]. However, reports on outcomes of pancreatoduodenectomy following PBD have been conflicting. Some studies have underlined increased pre-operative, intra-operative and postoperative complications related to PBD such as bleeding, pancreatitis, duodenal perforation, cholangitis, cholecystitis, cardiopulmonary events and miscellaneous [5][6][7][8][9][10][11][12]. In contrast, others have noted no adverse effect on perioperative and postoperative outcomes and on the other hand, some authors have even noticed amelioration of postoperative outcomes with this strategy's application [3].Based on these considerations, the role of preoperative biliary drainage remains a matter of controversies. To assess its effects on postoperative outcomes, we performed this retrospective study. Material and MethodsThis is a retrospective study, comparing preoperative biliary drainage with surgery alone in 200 jaundiced patients with pancreatic Keywords: Obstructive jaundice; Pancreatic head cancer; Preoperative biliary drainage; Post-operative outcomes IntrodutionPancreatic cancer is an aggressive neoplastic disease, with overall 5-years survival rate from all stages of less than 5%, making it, the 4th cause of cancer related death in the United States of America. Despite the innovation of diagnostic and therapeutic modalities during the year 2013 it was estimated that approximately [45] 2200 people were diagnosed with pancreatic adenocarcinoma and 38,460 died from it. With the majority of patients presenting with unrespectable tumor, locally advanced or metastatic disease and around 80% of patients are jaundiced [1]. For those with respectable tumor without evidence of metastasis, pancreaticoduodenectomy is the only option for cure, whereas radiation therapy, chemotherapy, and other newer experimental therapeutic modalities such as anti-hormonal therapy or systemic use of anti-pancreatic cancer cell monoclonal antibodies have not led to substantial prognostic improvements.Obstructive jaundice is thought to increase the risk of perioperative and postoperative complications [2]. Experimental studies performed on mice assigned to biliary ligation to induce obstructive jaundice showed significant complications in these animals such as coagulopathy, Cholangitis, hepatic dysfunction, intestinal barrier derangement, immunity dysfunction, wound healing retardation, renal dysfunction, cardio-pulmonary insufficiencies as well as endotoxemia. Understanding well the pathophysiology of obstructive jaundice related complications in 1935 Sir A.O. Whipple first introduced the concept of preoperative biliary drainage in jaundiced patients with pancreatic head cancer in order to improve postoperative outcomes. Subsequently, Carter contributed with a percutaneous trans hepatic-cholangiography (PTC). In the late 1960s, McCune propo...

show abstract

“…In cases where selective cannulation is not feasible, generally precut papillotomy techniques are performed. However, various complications including pancreatitis, perforation and bleeding are more common upon the use of precut techniques [5,9,10]. To reduce the ERCP-associated complication risk, it's important to have an experienced endoscopist, avoid unnecessary procedures, make adequate preparation before the procedure and operate cautiously [11].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Repeat ERCP: Analysis of a Four-Year Experience

Toros¹

2013

J Gastrointest Digest Sys

View full text Add to dashboard Cite

In this trial, a total of 1010 ERCP procedures performed in 410 patients at the endoscopy department of our hospital between 2006 and 2010, were retrospectively evaluated. The age, gender, complaints, pre-procedure diagnosis, the radiologic and clinical results, number of procedure repetitions and the final diagnosis were assessed. The local Ethics Committee approved this retrospective study protocol. All of the procedures were performed by the same team of endoscopists with compatible levels of ERCP experience (Mean 5 years). At our department, pethidine HCl (0.3-0.5 mg/kg), midazolam (0.03-0.07 mg/kg) and hyoscine-N-butylbromide (0.3-0.6 mg/kg) are used in the ERCP procedures for premedication and additionally, cefazolin 1 gram intravenous is routinely administered for prophyllaxis one hour before the examination. During the procedure, oxygen saturation and heart rate are monitored by pulse-oximeter. The patients were those admitted to our hospital or referred from other healthcare centers. Statistical assessment was performed by evaluating the first ERCP procedures and the repeat procedure records. Chi-square test was used to statistically analyze the results. The level of significance was set at p<0.05.

show abstract

Same-day discharge after endoscopic biliary sphincterotomy: observations from a prospective multicenter complication study

Cited by 71 publications

References 24 publications

Laparoscopic transcystic duct common bile duct exploration

Laparoscopic transcystic duct common bile duct exploration

Preoperative Biliary Drainage of Jaundiced Patients with Pancreatic Head Cancer: A Routine or Selective Strategy

Evaluation of Repeat ERCP: Analysis of a Four-Year Experience

Contact Info

Product

Resources

About