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Updates in Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis.
Gastroenterol Clin North Am
March 2025
Division of Gastrointestinal and Liver Diseases, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, Los Angeles, California, USA. Electronic address:
Although endoscopic retrograde cholangiopancreatography (ERCP) has been shown to be a safe and effective approach in treating these diseases while carrying lower morbidity than traditional surgical treatments, ERCP has associated risks, with post-ERCP pancreatitis (PEP) being the most common serious adverse event and carries significant morbidity and health care cost. PEP results from multifactorial factors involving trauma to the pancreatic duct and papilla, leading to subsequent obstruction and impairment of pancreatic drainage. Important risk factors for PEP include history of prior PEP, suspected sphincter of Oddi dysfunction, difficult cannulation, pancreatic duct contrast injections, and pancreatic sphincterotomy.
View Article and Find Full Text PDFManagement of Pancreatic Duct Strictures, Leaks, and Disconnected Pancreatic Duct Syndrome.
Gastroenterol Clin North Am
March 2025
Department of Gastroenterology, Post Graduate Institute of Medical Education and Research (PGIMER), Sector 12, Chandigarh 160012, India.
Pancreatic duct (PD) strictures, leaks, and disconnected ducts are important morphologic consequences of inflammatory disease of the pancreas, resulting in abdominal pain, pancreatic ascites, pancreatic pleural effusion, and external pancreatic fistula. Traditionally, these PD complications were treated surgically, but a better understanding of their pathophysiology, along with advancement in endoscopic interventions, has transformed the therapy from morbid surgical interventions to minimally invasive, safe, and effective endoscopic treatment. This review discusses the current diagnostic and management strategies for PD strictures, leaks, and disconnected pancreatic ducts.
View Article and Find Full Text PDFInitial Management of Acute Pancreatitis.
Gastroenterol Clin North Am
March 2025
Gastroenterology Department, Dr. Balmis General University Hospital, Alicante Institute of Health and Biomedical Research (ISABIAL), Servicio de Aparato Digestivo, 4 planta C, Pintor Baeza 12, 03010, Alicante, Spain; Clinical Medicine Department, Miguel Hernandez University, Campus UMH de Sant Joan, Edificio Francisco Javier Balmis, Carretera Nacional 332 s/n, 03550, San Juan de Alicante, Spain. Electronic address:
The initial management of acute pancreatitis (AP) is continually evolving. Goal-directed moderate fluid resuscitation is now preferred over more aggressive strategies. Antibiotics should be administered only when there is a proven or highly probable infection rather than for prophylactic purposes.
View Article and Find Full Text PDFClinical and Investigative Approach to Recurrent Acute Pancreatitis.
Gastroenterol Clin North Am
March 2025
Division of Gastroenterology and Hepatology, Oregon Health & Science University, Portland, OR, USA. Electronic address:
Recurrent acute pancreatitis (RAP) is a complex syndrome that presents variably, with many cases remaining idiopathic after thorough diagnostics. For evaluating structural etiologies, endoscopic ultrasound and MR cholangiopancreatography are preferred over endoscopic retrograde cholangiopancreatography (ERCP) given their more favorable risk profile and sensitivity. The diagnostic work-up remains paramount since treatment should focus on addressing underlying causes such as early cholecystectomy for gallstone pancreatitis.
View Article and Find Full Text PDFAlive in biliary fluid in patient: A case report.
World J Gastroenterol
January 2025
Department of Gastroenterology, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen 518000, Guangdong Province, China.
Background: (), is a prevalent parasitic worm that infects humans. It is found all over the world, particularly in tropical and subtropical areas. Strongyloidiasis is caused mostly by the parasitic nematode .
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