Cargando…

Timing of endoscopic therapy for acute bilio-pancreatic diseases: a practical overview

Diseases of the pancreas and hepatobiliary tree often require a therapeutic approach with endoscopic retrograde cholangiopancreatography (ERCP), generally following noninvasive imaging techniques. Appropriate indications and the correct timing for urgent ERCP would benefit both patients and clinicia...

Descripción completa

Detalles Bibliográficos
Autores principales: Buonocore, Matteo Rossano, Germani, Ugo, Castellani, Danilo, Petrogiannopoulos, Leonidas, Pallio, Socrate, Piciucchi, Matteo, Sbrozzi-Vanni, Andrea, Zullo, Angelo, Manta, Raffaele
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hellenic Society of Gastroenterology 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7903577/
https://www.ncbi.nlm.nih.gov/pubmed/33654349
http://dx.doi.org/10.20524/aog.2021.0580
Descripción
Sumario:Diseases of the pancreas and hepatobiliary tree often require a therapeutic approach with endoscopic retrograde cholangiopancreatography (ERCP), generally following noninvasive imaging techniques. Appropriate indications and the correct timing for urgent ERCP would benefit both patients and clinicians and allow optimal utilization of health resources. Indications for urgent (<24 h) ERCP include severe acute cholangitis, acute biliary pancreatitis with cholangitis, biliary or pancreatic leaks, in the absence of percutaneous drainage, and severe acute cholecystitis in patients who are unfit for surgery and do not respond to conservative management. In patients who have severe acute biliary pancreatitis with ongoing biliary obstruction but without cholangitis, early (<48-72 h) ERCP is indicated. This overview aims to provide decisional flowcharts that can be easily used for managing patients with acute bilio-pancreatic disorders when they are referred to the Emergency Department.