- Biliary Pancreatitis. Liver Function Tests and Common Biliopancreatic Channel Kinetics--Biliopancreatic Reflux. [Journal Article]Cir Esp 2015; 93(5):326-33CE
- CONCLUSIONS: BPR in BP increases cholestasis and contributes to confusion in the estimation of common bile duct stones increasing ERCP-EE rates. US and biochemical markers of CBDS show a low specificity due to BPR-CCBP which suggests that MRI-cholangiography is a mandatory exploration before ERCP-EE examination.
- [ERCP: ampulotomy or suprapapillary fistulotomy with needle knife to access bile duct in difficult cannulation]. [Clinical Trial]Rev Gastroenterol Peru 2012 Oct-Dec; 32(4):371-80RG
- CONCLUSIONS: In this case series, fistulotomy in difficult cannulation procedures had good efficacy. Is most prevalent in cases with odditis, gallstone impactation and ampulloma. Complications of the procedure are low.The fistulotomy type of pre-cut is leaded for patients who require therapeutic ERCP. The decision for doing the procedure must be precocious and informed consent is primordial.
- [Periampullar diverticulum--related to bilio-pancreatic disorders]. [Journal Article]Chirurgia (Bucur) 2010 Jan-Feb; 105(1):37-43C
- CONCLUSIONS: 1. PAD are related to bilio-pancreatic disorders, especially to bile duct stones. 2. The most common physio-pathological mechanism is a alteration of the bile flow, due to angulation, compression and/or obstruction of the final part of the bile duct and Wirsung duct, followed by secondary upper stasis. 3. Papillosphincterotomy has technical particularities, because of difficulties in incision orientation (a deformed papilla, with modified anatomical relationships, being situated profound inside the diverticulum cavity). Sphincterotomy depth was limited, which lead to less succesfull extraction of bile stones (89%, compared to the control group 92%). 4. We did not encounter major accidents. Secondary acute pancreatitis after ERCP was similar in both study groups. There was no significant difference in morbidity and mortality rates in both groups.
- Easy sphincterotomy in patients with Billroth II gastrectomy: a new technique. [Journal Article]Turk J Gastroenterol 2008; 19(2):109-13TJ
- CONCLUSIONS: In this pilot study, endoscopic sphincterotomy with a new guidewire sphincterotome in patients with Billroth II gastrectomy was found to be clinically successful, concise, easy to perform, efficient, and reliable. However, further large comparative studies are needed for a definite conclusion.
- Sphincterotomy for biliary sphincter of Oddi dysfunction. [Review]Cochrane Database Syst Rev 2001; (3):CD001509CD
- CONCLUSIONS: These results suggest that sphincterotomy for biliary sphincter of Oddi dysfunction appears effective in those patients with an elevated sphincter of Oddi basal pressure (>40 mmHg), but is no better than placebo in those patients with a normal basal pressure. The results reported in this review must be interpreted with caution as there are only two studies and one of the reviewers (Toouli) has been an author in both studies. Further trials by independent groups are recommended.
- [Clinical difficulties and errors in making a diagnosis of chronic papillo-odditis]. [Journal Article]Vutr Boles 1999; 31(4):5-8VB
- 138 patients with chronic papillooditis were investigated, 15 of them in a stage of decompensation. In 83.3% of the cases, the diagnosis was not clinically determined (including 68 of 92 endoscoped before their hospitalization--82.9%). 34 patients were diagnosed as having chronic gastroduodenitis, 15--ulcer, 42--chronic cholecystitis, 11--chronic pancreatitis, 4--cholangitis, 9--postcholecystecto…
138 patients with chronic papillooditis were investigated, 15 of them in a stage of decompensation. In 83.3% of the cases, the diagnosis was not clinically determined (including 68 of 92 endoscoped before their hospitalization--82.9%). 34 patients were diagnosed as having chronic gastroduodenitis, 15--ulcer, 42--chronic cholecystitis, 11--chronic pancreatitis, 4--cholangitis, 9--postcholecystectomic status. All these diseases developed simultaneously with the papillitis. In a second endoscopic check-up with an examination of papilla Vateri, the patients were in all the cases diagnosed without difficulties and the diagnose was confirmed by biopsy. In 21 patients there was confirmed primary papillooditis and in 127--accompanying disorders: chr. gastroduodenitis--29, chr. atrophic gastritis--18, ulcer--15, chr. cholecystitis--42, postcholecystectomic status--9, choledocholithiasis--14, chr. pancreatitis--11. Most often misdiagnosis occurs if: 1) during the routine endoscopic investigation the endoscopist does not examine papilla of Vater; 2) chr. papillitis exists simultaneously with one of the already mentioned diseases that are easier of approach for diagnostics and explanation of the disorders; 3) the clinical picture of papillitis cannot be differentiated from the one of the basic or accompanying disease; 4) the bile drainage is not prevented; 5) the result of the venous biligraphy does not lead to the diagnosis and ERCP is carried out only in a case of a clinical suspicion.
- [Intra-operative identification of the ostium of Wirsung's pancreatic duct after papillosphincterotomy]. [Journal Article]Rev Assoc Med Bras (1992) 1999 Apr-Jun; 45(2):99-104RA
- CONCLUSIONS: The transoperative determination of the dimensions as proposed in this study, allows a safety detection and cannulation of the Wirsung's duct with or without inflammation of the Oddi's sphincter.
- Chronic obstructive pancreatitis in humans is a lithiasic disease. [Journal Article]Pancreas 1996; 13(1):66-70P
- In humans chronic obstructive pancreatitis (COP) is thought to be a disease devoid of ductal stones. The aim of this study was to verify the presence and frequency of calcifications in patients with COP and compare them with those found in patients with chronic calcifying/calcific pancreatitis (CCP). We conducted a retrospective ERCP investigation in 115 patients with documented chronic pancreati…
In humans chronic obstructive pancreatitis (COP) is thought to be a disease devoid of ductal stones. The aim of this study was to verify the presence and frequency of calcifications in patients with COP and compare them with those found in patients with chronic calcifying/calcific pancreatitis (CCP). We conducted a retrospective ERCP investigation in 115 patients with documented chronic pancreatitis. Only 75 could be safely classified as COP or CCP. Fifty-three patients (M:F ratio, 5.6:1; mean age, 36.1 +/- 12.2 years) had CCP, 46 of whom (86.8%) with calcifications. Twenty-two patients (M:F ratio, 3.4:1; mean age, 45.3 +/- 16.2 years; p < 0.05 vs. CCP) presented COP at endoscopic retrograde cholangiopancreatography, 8 (36.4%) with ductal calcifications (p < 0.0001 vs. CCP). COP was secondary to acute pancreatitis in nine cases, to odditis in 11 cases, and to malignant tumor and hypertrophy of Oddi's sphincter, respectively, in the other two cases. The two patient groups showed no significant differences in drinking and smoking habits, number of painful relapses, disease duration, and incidence of diabetes, gallstones, and need for surgery. In conclusion, formation of ductal stones is by no means rare in COP and should be classified as a form of lithiasic pancreatitis. Early restoration of pancreatic outflow by removing the obstruction, or by shunt-type operations and abstinence from drinking and smoking, should resolve this type of disease.
- [Endoscopy and laparoscopy in the treatment of lithiasic cholecystitis associated with benign bile duct obstruction]. [Journal Article]Rev Invest Clin 1995 Mar-Apr; 47(2):103-7RI
- CONCLUSIONS: The combined approach using ERCP followed by laparoscopic cholecystectomy seems to be adequate for the treatment of gallstones associated to bile duct obstruction.
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- [Atypical anatomical variants and anomalies of the biliary tract in patients with biliary tract and pancreatic diseases. II. Endoscopic treatment]. [Journal Article]Khirurgiia (Sofiia) 1991; 44(1):8-12K
- Results are reported of endoscopic treatment of 79 patients with atypical anatomical variants and anomalies of the bile ducts: common bile duct calculosis (54), stenosing papillo-odditis (8), indurative pancreatitis (2) and bile duct cancer (15). The following endoscopic manipulations have been performed: endoscopic sphincterotomy (72); hydrostatic balloon extraction of calculi (27); hydrostatic …
Results are reported of endoscopic treatment of 79 patients with atypical anatomical variants and anomalies of the bile ducts: common bile duct calculosis (54), stenosing papillo-odditis (8), indurative pancreatitis (2) and bile duct cancer (15). The following endoscopic manipulations have been performed: endoscopic sphincterotomy (72); hydrostatic balloon extraction of calculi (27); hydrostatic balloon dilatation of constricted segments (29); mechanical lithotripsy (15); nasolabial drainage (17) and endoprosthesis (15). Much more difficult was the extraction of calculi from the common bile in the event of atypical anatomical variants and anomalies of the distal portion of the common bile duct (chi 2 = 14.55; p less than 0.001). Treatment resulted in significant reduction of the bilirubin levels (t = 4.13; p less than 0.001), of AP (t = 4.47; p less than 0.001), GGTP (t = 4.07; p less than 0.001); AcAT (t = 5.75; p less than 0.001) and AlAT (t = 5.63; p less than 0.001). Complications occurred in 6 per cent of the patients (acute pancreatitis, cholangitis, hemorrhage). Mortality from endoscopic treatment was 1.3 per cent. Endoscopic methods for treatment are advised as alternative to operative treatment for patients in advanced age and high operative risk.