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Endoscopic Interventions for the Early and Remission Phases of Acute Biliary Pancreatitis: What are the More Concrete and Practical Situations for Performing Them?
BACKGROUND/AIMS: The use of endoscopic intervention (EI) for acute biliary pancreatitis (ABP) remains controversial because the severity of biliary obstruction/cholangitis/pancreatitis is not reflected in the indications for early EI (EEI). METHODS: A total of 148 patients with ABP were included to...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Korean Society of Gastrointestinal Endoscopy
2021
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8652157/ https://www.ncbi.nlm.nih.gov/pubmed/34038997 http://dx.doi.org/10.5946/ce.2020.271 |
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author | Hasegawa, Sho Koshita, Shinsuke Kanno, Yoshihide Ogawa, Takahisa Sakai, Toshitaka Kusunose, Hiroaki Kubota, Kensuke Nakajima, Atsushi Noda, Yutaka Ito, Kei |
author_facet | Hasegawa, Sho Koshita, Shinsuke Kanno, Yoshihide Ogawa, Takahisa Sakai, Toshitaka Kusunose, Hiroaki Kubota, Kensuke Nakajima, Atsushi Noda, Yutaka Ito, Kei |
author_sort | Hasegawa, Sho |
collection | PubMed |
description | BACKGROUND/AIMS: The use of endoscopic intervention (EI) for acute biliary pancreatitis (ABP) remains controversial because the severity of biliary obstruction/cholangitis/pancreatitis is not reflected in the indications for early EI (EEI). METHODS: A total of 148 patients with ABP were included to investigate 1) the differences in the rate of worsening cholangitis/pancreatitis between the EEI group and the early conservative management (ECM) group, especially for each severity of cholangitis/pancreatitis, and 2) the diagnostic ability of imaging studies, including endoscopic ultrasound (EUS), to detect common bile duct stones (CBDSs) in the ECM group. RESULTS: No differences were observed in the rate of worsening cholangitis between the EEI and ECM groups, regardless of the severity of cholangitis and/or the existence of impacted CBDSs. Among patients without impacted CBDSs and moderate/severe cholangitis, worsening pancreatitis was significantly more frequent in the EEI group (18% vs. 4%, <i>p</i>=0.048). In patients in the ECM group, the sensitivity and specificity for detecting CBDSs were 73% and 98%, respectively, for EUS, whereas the values were 13% and 92%, respectively, for magnetic resonance cholangiopancreatography. CONCLUSIONS: EEI should be avoided in the absence of moderate/severe cholangitis and/or impacted CBDSs because of the high rate of worsening pancreatitis. EUS can contribute to the accurate detection of residual CBDSs, for the determination of the need for elective EI. |
format | Online Article Text |
id | pubmed-8652157 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Korean Society of Gastrointestinal Endoscopy |
record_format | MEDLINE/PubMed |
spelling | pubmed-86521572021-12-20 Endoscopic Interventions for the Early and Remission Phases of Acute Biliary Pancreatitis: What are the More Concrete and Practical Situations for Performing Them? Hasegawa, Sho Koshita, Shinsuke Kanno, Yoshihide Ogawa, Takahisa Sakai, Toshitaka Kusunose, Hiroaki Kubota, Kensuke Nakajima, Atsushi Noda, Yutaka Ito, Kei Clin Endosc Original Article BACKGROUND/AIMS: The use of endoscopic intervention (EI) for acute biliary pancreatitis (ABP) remains controversial because the severity of biliary obstruction/cholangitis/pancreatitis is not reflected in the indications for early EI (EEI). METHODS: A total of 148 patients with ABP were included to investigate 1) the differences in the rate of worsening cholangitis/pancreatitis between the EEI group and the early conservative management (ECM) group, especially for each severity of cholangitis/pancreatitis, and 2) the diagnostic ability of imaging studies, including endoscopic ultrasound (EUS), to detect common bile duct stones (CBDSs) in the ECM group. RESULTS: No differences were observed in the rate of worsening cholangitis between the EEI and ECM groups, regardless of the severity of cholangitis and/or the existence of impacted CBDSs. Among patients without impacted CBDSs and moderate/severe cholangitis, worsening pancreatitis was significantly more frequent in the EEI group (18% vs. 4%, <i>p</i>=0.048). In patients in the ECM group, the sensitivity and specificity for detecting CBDSs were 73% and 98%, respectively, for EUS, whereas the values were 13% and 92%, respectively, for magnetic resonance cholangiopancreatography. CONCLUSIONS: EEI should be avoided in the absence of moderate/severe cholangitis and/or impacted CBDSs because of the high rate of worsening pancreatitis. EUS can contribute to the accurate detection of residual CBDSs, for the determination of the need for elective EI. Korean Society of Gastrointestinal Endoscopy 2021-11 2021-05-27 /pmc/articles/PMC8652157/ /pubmed/34038997 http://dx.doi.org/10.5946/ce.2020.271 Text en Copyright © 2021 Korean Society of Gastrointestinal Endoscopy https://creativecommons.org/licenses/by-nc/3.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Hasegawa, Sho Koshita, Shinsuke Kanno, Yoshihide Ogawa, Takahisa Sakai, Toshitaka Kusunose, Hiroaki Kubota, Kensuke Nakajima, Atsushi Noda, Yutaka Ito, Kei Endoscopic Interventions for the Early and Remission Phases of Acute Biliary Pancreatitis: What are the More Concrete and Practical Situations for Performing Them? |
title | Endoscopic Interventions for the Early and Remission Phases of Acute Biliary Pancreatitis: What are the More Concrete and Practical Situations for Performing Them? |
title_full | Endoscopic Interventions for the Early and Remission Phases of Acute Biliary Pancreatitis: What are the More Concrete and Practical Situations for Performing Them? |
title_fullStr | Endoscopic Interventions for the Early and Remission Phases of Acute Biliary Pancreatitis: What are the More Concrete and Practical Situations for Performing Them? |
title_full_unstemmed | Endoscopic Interventions for the Early and Remission Phases of Acute Biliary Pancreatitis: What are the More Concrete and Practical Situations for Performing Them? |
title_short | Endoscopic Interventions for the Early and Remission Phases of Acute Biliary Pancreatitis: What are the More Concrete and Practical Situations for Performing Them? |
title_sort | endoscopic interventions for the early and remission phases of acute biliary pancreatitis: what are the more concrete and practical situations for performing them? |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8652157/ https://www.ncbi.nlm.nih.gov/pubmed/34038997 http://dx.doi.org/10.5946/ce.2020.271 |
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