Context: The incidence of post-ERCP pancreatitis is 1-22%. It continues to be a difficult problem for endoscopist and patient. Uncovering an agent that may be used to prevent its occurrence is critical.
Objective: The aim of our study was to investigate the role of etanercept in the prevention of post-ERCP pancreatitis.
Design: Endoscopic retrograde pancreatography (ERP)-induced injury was performed in dogs using a previously established endoscopic model of post-ERCP pancreatitis.
Animals: Eight study dogs underwent ERP: 4 were pre-treated with etanercept one day before the procedure and 4 were untreated. In addition, three control dogs not undergoing ERP were also studied.
Main Outcome Measures: Serum levels of amylase, lipase, and TNF-alpha, as well as the ratio of urinary trypsinogen activation peptide (TAP) and urinary creatinine, were measured before and after ERP. Necropsy was performed on post-operative day 5. All pancreatic specimens were graded by two blinded pathologists according to a validated scoring system.
Results: Eight study dogs developed mild to moderate clinical pancreatitis with hyperamylasemia (11,538+/-4,065 U/L vs. 701+/-157 U/L; post-ERP peak levels vs. baseline values: P<0.001) and hyperlipasemia (3,637+/-2,333 U/L vs. 246+/-125 U/L; P=0.003). Mean total injury score was significantly elevated in study dogs compared to control dogs (6.16+/-1.85 vs. 1.06+/-0.49; P=0.001). There were escalating total injury scores concordant with more elaborate methods of endoscopically-induced injury although the trend did not reach the statistical significance (P=0.223). When comparing untreated to etanercept-treated dogs, there were no significant differences in serum amylase levels (P=0.903), serum lipase levels (P=0.771), TAP/creatinine urinary ratio (P=0.912), and pancreatic injury score (P=0.324).
Conclusion: Etanercept is ineffective in prevention of mild to moderate post-ERCP pancreatitis in canines. ERP-induced pancreatic injury can be used as a reliable animal model for studies investigating therapy and prevention of post-ERCP pancreatitis.
Download full-text PDF |
Source |
|---|
Publication Analysis
Top Keywords
Similar Publications
Prevention of Bacterial Infection in Biliary and Pancreatic Endoscopy-A Review.
Diagnostics (Basel)
December 2024
Department of Gastroenterology and Internal Medicine, Medical University of Warsaw, 02-097 Warsaw, Poland.
Background: Endoscopic retrograde cholangiopancreatography (ERCP) is a key therapeutic procedure in diseases of the pancreas or bile ducts. The understanding and effective management of the risks associated with the procedure, especially in the context of possible infectious complications, is crucial for patients' safety. The aim of this review was to analyze the results of studies on antibiotic prophylaxis for infectious complications of ERCP, pancreatoscopy, and cholangioscopy.
View Article and Find Full Text PDFPost Endoscopic Retrograde Cholangiopancreatography Pancreatitis: Novel Mechanisms and Prevention by Drugs.
United European Gastroenterol J
December 2024
Division of Gastroenterology, Department of Pediatrics, School of Medicine, Stanford University, Stanford, California, USA.
Endoscopic retrograde cholangiopancreatography (ERCP) is becoming more common than first-line therapy for pancreaticobiliary duct disorders. However, post-ERCP pancreatitis is the most common complication of ERCPs, and affects about 10% of cases. In this review, we provide an overview of the mechanisms purported to cause post-ERCP pancreatitis as well as associated risk factors.
View Article and Find Full Text PDFIntrahepatic Rupture of Acute Cholecystitis Complicated by Septic Portal Thrombosis.
Cureus
November 2024
Surgery, Northeast Georgia Medical Center Gainesville, Gainesville, USA.
Gallbladder rupture, though rare, is a serious complication often arising from choledocholithiasis and subsequent interventions such as endoscopic retrograde cholangiopancreatography (ERCP). In this case, the patient presented with acute choledocholithiasis and underwent ERCP with sphincterotomy and stone extraction, followed by placement of a fully covered metal stent in the common bile duct (CBD). While the use of covered stents is appropriate, it is important to note that these stents can obstruct the cystic duct orifice in patients with a gallbladder.
View Article and Find Full Text PDFPredictors of Post-ERCP Pancreatitis: A Comprehensive Systematic Review and Meta-Analysis.
Clin Gastroenterol Hepatol
December 2024
Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, IN.
Background And Aims: Pancreatitis is the most common serious adverse event associated with endoscopic retrograde cholangiopancreatography (ERCP). This meta-analysis aimed to precisely assess the risk factors for post-ERCP pancreatitis (PEP).
Methods: We searched electronic databases for studies that assessed risk factors for PEP after adjusting for ≥3 risk factors, including at least one pre-specified patient-related and one procedure-related risk factor, and reported the data as adjusted odds ratios (OR) with 95% confidence intervals.
Pancreaticopleural fistula: a rare aetiology of pleural effusion.
BMJ Case Rep
December 2024
General and Upper Gastrointestinal Surgery, NHS Lanarkshire, Bothwell, South Lanarkshire, UK.
Pancreaticopleural fistula (PPF) is a rare complication of chronic pancreatitis, which clinically presents as a pleural effusion and often with an absence of typical abdominal symptoms associated with pancreatic disease.We describe a man in his early 50s who presented to the emergency department with pleuritic chest pain and progressive breathlessness with a history of alcohol excess. Chest X-ray demonstrated a bilateral pleural effusion with a dark red amylase-rich exudate on needle aspiration, necessitating a chest drain insertion.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!