Background: Previous studies have revealed that patients with asymptomatic common bile duct (CBD) stones are at a high risk of developing post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP). However, no studies to date have addressed the risk factors for PEP in patients with asymptomatic CBD stones.
Aim: To examine the risk factors for PEP in patients with asymptomatic CBD stones.
Methods: Using medical records of three institutions in Japan for 6 years, we identified a total of 1135 patients with choledocholithiasis including 967 symptomatic patients and 168 asymptomatic patients with native papilla who underwent therapeutic ERCP. We performed univariate and multivariate analyses to examine the risk factors for PEP in the 168 patients with asymptomatic CBD stones.
Results: The overall incidence rate of PEP in all the patients with during study period was 4.7% (53/1135). Of the 168 patients with asymptomatic CBD stones, 24 (14.3%) developed PEP. In univariate analysis, precut sphincterotomy ( = 0.009) and biliary balloon sphincter dilation ( = 0.043) were significant risk factors for PEP. In multivariate analysis, precut sphincterotomy ( = 0.002, 95%CI: 2.2-27.8, odds ratio = 7.7), biliary balloon sphincter dilation ( = 0.015, 95%CI: 1.4-17.3, odds ratio = 4.9), and trainee endoscopists ( = 0.048, 95%CI: 1.01-8.1, odds ratio = 2.9) were significant risk factors for PEP.
Conclusion: ERCP for asymptomatic CBD stones should be performed by experienced endoscopists. When performing precut sphincterotomy or biliary balloon sphincter dilation in patients with asymptomatic CBD stones, the placement of a prophylactic pancreatic stent is strongly recommended to prevent PEP.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6885445 | PMC |
| http://dx.doi.org/10.4253/wjge.v11.i10.515 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Clinical Phenotype and Prognosis of Asymptomatic Patients With Transthyretin Cardiac Amyloid Infiltration.
JAMA Cardiol
January 2025
National Amyloidosis Centre, Division of Medicine, University College London, Royal Free Hospital, London, United Kingdom.
Importance: Patients with transthyretin (ATTR) cardiac amyloid infiltration are increasingly diagnosed at earlier disease stages with no heart failure (HF) symptoms and a wide range of cardiac amyloid infiltration.
Objective: To characterize the clinical phenotype and natural history of asymptomatic patients with ATTR cardiac amyloid infiltration.
Design, Setting, And Participants: This cohort study analyzed data of all patients at 12 international centers for amyloidosis from January 1, 2008, through December 31, 2023.
Effects of Continuous Graduated Pneumatic Compression and Intermittent Pneumatic Compression on Lower Limb Hemodynamics for VTE Prophylaxis in Arthroplasty.
Orthop Surg
January 2025
Department of Orthopedics, Qilu Hospital of Shandong University, Jinan, China.
Objective: Intermittent pneumatic compression (IPC) is considered the standard of care for preventing venous thromboembolism (VTE) in the hospital setting. However, its widespread adoption after hospitalization has been limited due to its shortcomings in obstruction of venous valves and blood reflux. The objective of this study is to compare the effects of continuous graduated pneumatic compression (CGPC), a new device with a novel mechanism, and IPC on lower hemodynamics and the incidence of VTE in patients undergoing arthroplasty.
View Article and Find Full Text PDFErdheim Chester Disease with Calvarial Involvement: A rare case of Histiocytosis.
Turk Neurosurg
March 2024
SBÜ Gaziosmanpaşa Eğitim ve Araştırma Hastanesi.
Erdheim-Chester Disease is a rare systemic xanthogranulomatous infiltrating disease, characterized by lipid-laden histiocytes accumulating in various organs and almost always in bones. Etiology of the disease is still unknown. It may involve various organs and systems, such as musculoskeletal, cardiac, pulmonary, renal, gastrointestinal and central nervous system (CNS) as well as the skin.
View Article and Find Full Text PDFExtensive Inactive Neurocysticercosis: A Case Report in Mbeya, Southern Highlands of Tanzania.
Int Med Case Rep J
January 2025
Kilimanjaro Christian Medical University College of Tumaini University, Moshi, Tanzania.
Background: Neurocysticercosis (NCC) and Acquired Human Immunodeficiency Syndrome (AIDS) are both highly prevalent in Africa. Clinical presentation of NCC ranges from asymptomatic to manifestations, including epileptic seizures, severe progressive headache, and focal neurological deficits. It is influenced by the number, size, location, and stage of the cysts, as well as the parasite's potential to cause inflammation and the immunological response of the host.
View Article and Find Full Text PDFA Mysterious Cause of Coagulopathy With Bleeding Diathesis.
Cureus
December 2024
Department of Internal Medicine IV, Hospital Professor Doutor Fernando Fonseca, Amadora, PRT.
Vitamin K is essential to produce functional vitamin K-dependent coagulation factors (prothrombin, factors VII, IX, and X). Vitamin K antagonists inhibit the normal activation of these factors, leading to bleeding manifestations of variable severity. Long-acting vitamin K antagonists or superwarfarins were developed as rodenticides and have a significantly longer half-life and greater potency when compared to warfarin.
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!