Publications by authors named "S L KEILIN"

Article Synopsis
  • Difficult biliary cannulation (DBC) significantly raises the risk of post-ERCP pancreatitis (PEP), especially when combined with high pre-procedure risk factors.
  • In a study with 1,601 participants, those undergoing DBC faced a PEP rate of 20.7% when they also had high pre-procedure risk, compared to lower rates for non-DBC groups.
  • Prophylactic measures, such as combining rectal indomethacin with pancreatic duct stenting, were found to effectively reduce the risk of PEP, even with an increasing number of PD wire passages during DBC.
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Introduction: Prophylactic pancreatic stent placement (PSP) is effective for preventing pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP) in high-risk cases, but the optimal technical approach to this intervention remains uncertain.

Methods: In this secondary analysis of 787 clinical trial patients who underwent successful stent placement, we studied the impact of (i) whether pancreatic wire access was achieved for the sole purpose of PSP or naturally during the conduct of the case, (ii) the amount of effort expended on PSP, (iii) stent length, (iv) stent diameter, and (v) guidewire caliber. We used logistic regression models to examine the adjusted association between each technical factor and post-ERCP pancreatitis (PEP).

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Background And Aims: Insulinomas are among the most common types of functional pancreatic neuroendocrine tumors and can cause debilitating, recurrent, symptomatic hypoglycemia. Pancreatic resection can be curative, but many patients are not candidates for major pancreatic surgery. EUS-guided radiofrequency ablation (EUS-RFA) is a novel minimally invasive technique for ablation of pancreatic tumors.

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Background: The combination of rectally administered indomethacin and placement of a prophylactic pancreatic stent is recommended to prevent pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP) in high-risk patients. Preliminary evidence suggests that the use of indomethacin might eliminate or substantially reduce the need for stent placement, a technically complex, costly, and potentially harmful intervention.

Methods: In this randomised, non-inferiority trial conducted at 20 referral centres in the USA and Canada, patients (aged ≥18 years) at high risk for post-ERCP pancreatitis were randomly assigned (1:1) to receive rectal indomethacin alone or the combination of indomethacin plus a prophylactic pancreatic stent.

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A new biliary duct (BD) stricture raises questions about the presence of malignancy, especially with a history of metastatic pancreatic cancer. A few cases of colloid carcinoma (CC) of the pancreas have been published, but none have described recurrence in the biliary tract. We report a case of intrahepatic biliary CC that recurred after two years after the last dose of immunotherapy for pancreatic CC.

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