[Complications in diagnostic and therapeutic endoscopic cholangiopancreatography. Prospective study].

Background: Studies of ERCP-related morbidity seldom include a sufficient patient follow-up. The complication rate is variable.

Aim: To characterize and to evaluate the frequency of complications in patients after Diagnostic and Therapeutic ERCP.

[Therapeutic endoscopy in pancreas].

The role of endoscopic retrograde cholangiopancreatography (ERCP) in the management of pancreatic disease is continuing to evolve. In view of increasingly noninvasive diagnostic imaging modalities for pancreatic disease, ERCP should be mainly restricted to therapeutic indications. This article reviews recent publications spanning a wide range of topics related to therapeutic pancreatic endoscopy: This review article will be focused on the technical and therapeutic aspects of the following topics: 1.

[Self-expandable metallic biliary endoprosthesis in malignant obstructive jaundice].

Background: Implantation of metallic stents for malignant biliary strictures has been recognized to be effective alternatives.

Aim: To show our experience in metallic stents for palliation of malignant biliary strictures.

Patients And Methods: Seventy three patients (38 males, 35 females, mean age 64.

[Transpapillary and transmural drainage of pancreatic pseudocysts].

Background: Endoscopic treatment of pancreatic pseudocysts via cystoenterostomy or transpapillary stenting has been recognized as a successful treatment options in carefully selected patients. Transpapillary stenting is an option in patients with pancreatic pseudocysts directly communicating with the main duct.

Aim: The aim of this study was to assess the safety and usefulness of transpapillary pancreatic endoprosthesis and transmural drainage in the treatment of symptomatic pancreatic pseudocysts.

[Endoscopic mechanical lithotripsy in choledocholithiasis of difficult extraction handling].

Background: Large stones are difficult to remove in block through a small papillotomy, a relative narrowed distal bile duct, periampular diverticula or in those who have undergone only balloon sphincteroplasty prior to stone extraction. Extending the papillotomy is not always possible, and may carry, an increased risk of bleeding and perforation. Lithotripsy facilitates stone extraction and clearance of the common bile duct.

[Endoscopic treatment of idiopathic recurrent chronic pancreatitis in children and adolescents].

Background: The use of diagnostic and therapeutic endoscopic retrograde cholangiopancreatography (ERCP) is increasing in the management of pancreatobiliary diseases in children.

Aim: Report our experience with ERCP in the management of chronic recurrent idiopathic pancreatitis in children.

Patients And Methods: Over a 12-year period we performed 56 ERCP for the treatment of chronic recurrent idiopathic pancreatitis in 20 patients which clinical status was assessed six months before the first ERCP and six months after the last ERCP.

[Postoperative biliary stenosis: long-term results of endoscopic treatment].

Background: Endoscopic stent placement is often the initial therapy in symptomatic patients with postoperative strictures because patients are usually diagnosed at the time of ERCP. Although stent insertion rapidly relieves symptoms of biliary obstruction and can even be live-saving in patients with cholangitis, all stents eventually clog, necessitating regular stent changes every 3 to 4 months. Results from several groups suggested that placing multiple stents for months to years could dilate the stricture permanently and thus also treat patients with postoperative biliary strictures palliatively.

[Endoscopic sphincterotomy as an out-patient procedure: is it safe?].

Background: Patients have been routinely admitted for observation for potential complications after therapeutic ERCP; however, in this era of cost containment it may be more cost-effective to perform these procedures on an out-patient basis.

Aim: The purpose of this study was to determine safety and complication rates of endoscopic sphincterotomy in out-patients.

Materials And Patients: Over an 11-month period, 124 consecutive patient undergoing endoscopic sphincterotomy for biliary and pancreatic disease were enrolled in a prospective and randomized manner.

[Endoscopic management of choledocholithiasis during pregnancy].

Background: Gallstones and extrahepatic biliary obstruction is a difficult management problem during pregnancy. Choledocholithiasis may cause cholangitis or pancreatitis, potentially life-threatening conditions. As surgery may result in significant fetal mortality when performed on these patients.

[Conservative management of duodenal perforation following endoscopic sphincterotomy of papilla of Vater].

Background: Endoscopic sphincterotomy (ES) is an established procedure in treatment of diseases of the biliary tract; management of serious complications such as duodenal perforation remains controversial. Because mortality is high if sepsis is inadequately treated by no use of operative means, many surgeons advocate routine operative repair and drainage upon diagnosis. In surveys of large experiences, however, the majority patients initially were treated non-surgically, and the majority recovered.

[Endoscopic diagnosis and treatment of non-traumatic bilhemia. A case report].

Biliovascular fistulas are abnormal communications with two types of clinical manifestations depending on type of flow in fistulous tract: 1) hemorrhage into biliary tract known as hemobilia, or 2) bile into bloodstream, known as bilhemia. Historically, this complication has been treated with surgery; however, technological progress at present allows treatment with intervention techniques without surgery being mandatory. In 1975, Clemens and Wittrin introduced the term bilhemia, a rare complication of hepatic damage producing excessively high levels of serum bilirubin and moderate rise of hepatic enzymes secondary to post-traumatic intrahepatic biliovenous fistula.

[Selection criteria for endoscopic cholangiopancreatography before laparoscopic cholecystectomy].

Background: The unexpected detection of stones in common bile duct during laparoscopic cholecystectomy is a concern for laparoscopic surgeons. Immediate laparoscopic removal may not always be feasible due to inadequate operating facilities, surgeons, and assistants. Attempts have been made to identify clinical and biochemical predictor of common bile duct stones, the results of which have not been consistent.