nach oben

Journal of Gastrointestinal Surgery

Erschienen in:

28.02.2019 | Evidence-Based Current Surgical Practice

Endoscopic Management of Acute Biliopancreatic Disorders

verfasst von: Ryan M. Juza, Eric M. Pauli

Erschienen in: Journal of Gastrointestinal Surgery | Ausgabe 5/2019

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Endoscopy is playing an ever-increasing role in the management of acute biliopancreatic disorders. With the management paradigm shifting away from more invasive surgical approaches, surgeons need to be aware of the treatment options available to improve patient care. Our manuscript serves to improve surgeons’ knowledge and understanding of these emerging treatment modalities to expand their algorithmic approach to biliopancreatic disorders.

Methods

Specific acute biliopancreatic disorders were identified from the literature and personal practice to create a structured review of common problems experienced by a surgeon of the gastrointestinal tract. An exhaustive literature review was performed to identify and analyze endoscopic treatment modalities for these disorders.

Results

Endoscopic therapies continue to expand rapidly with a robust supportive literature. Data on endoscopic treatment strategies for acute biliopancreatic disorders demonstrate valuable improvements in outcomes in a number of these disorders.

Discussion

Acute biliopancreatic disorders represent one of the most challenging pathophysiologies that a surgeon of the gastrointestinal tract may face. This manuscript represents a review of available endoscopic instrumentation as well as the author’s interpretation of the current literature regarding indications and outcomes of endoscopic management for acute biliopancreatic disorders. Although this article does not supplant formal training in therapeutic endoscopy, surgeons reading this article should understand the role endoscopy plays in the management of acute biliopancreatic disorders.

Barkun AN, Rezieg M, Mehta SN, Pavone E, Landry S, Barkun JS, Fried GM, Bret P, Cohen A. Postcholecystectomy biliary leaks in the laparoscopic era: risk factors, presentation, and management. McGill Gallstone Treatment Group. Gastrointest Endosc. 1997 Mar;45(3):277–82

Guarise A, Baltieri S, Mainardi P, Faccioli N. Diagnostic accuracy of MRCP in choledocholithiasis. Radiol Med. 2005 Mar;109(3):239–51PubMed

Anderloni A, Repici A. Role and timing of endoscopy in acute biliary pancreatitis. World J Gastroenterol. 2015 Oct 28;21(40):11205–8CrossRef

Giljaca V, Gurusamy KS, Takwoingi Y, Higgie D, Poropat G, Štimac D, Davidson BR. Endoscopic ultrasound versus magnetic resonance cholangiopancreatography for common bile duct stones. Cochrane Database Syst Rev. 2015 Feb 26;(2)

ASGE Standards of Practice Committee, Maple JT, Ben-Menachem T, Anderson MA, Appalaneni V, Banerjee S, Cash BD, Fisher L, Harrison ME, Fanelli RD, Fukami N, Ikenberry SO, Jain R, Khan K, Krinsky ML, Strohmeyer L, Dominitz JA. The role of endoscopy in the evaluation of suspected choledocholithiasis. Gastrointest Endosc. 2010 Jan;71(1):1–9CrossRef

ASGE Standards of Practice Committee, Faulx AL, Lightdale JR, Acosta RD, Agrawal D, Bruining DH, Chandrasekhara V, Eloubeidi MA, Fanelli RD, Gurudu SR, Kelsey L, Khashab MA, Kothari S, Muthusamy VR, Qumseya BJ, Shaukat A, Wang A, Wani SB, Yang J, DeWitt JM (2017) Guidelines for privileging, credentialing, and proctoring to perform GI endoscopy. Gastrointest Endosc 85:273–281.CrossRef

Springer J, Enns R, Romagnuolo J, Ponich T, Barkun AN, Armstrong D (2008) Canadian credentialing guidelines for endoscopic retrograde cholangiopancreatography. Can J Gastroenterol J Can Gastroenterol 22:547–551CrossRef

Shahidi N, Ou G, Telford J, Enns R (2015) When trainees reach competency in performing ERCP: a systematic review. Gastrointest Endosc 81:1337–1342.CrossRef

Ekkelenkamp VE, Koch AD, Rauws EAJ, Borsboom GJJM., de Man RA, Kuipers EJ (2014) Competence development in ERCP: the learning curve of novice trainees. Endoscopy 46:949–955.CrossRef

10.

Al-Mansour MR, Fung EC, Jones EL, Zayan NE, Wetzel TD, Martin Del Campo SE, Jalilvand AD, Suzo AJ, Dettorre RR, Fullerton JK, Meara MP, Mellinger JD, Narula VK, Hazey JW. Surgeon-performed endoscopic retrograde cholangiopancreatography.Outcomes of 2392 procedures at two tertiary care centers. Surg Endosc. 2017 Dec 22

11.

Ryberg AA, Fitzgibbons RJ Jr, Tseng A, Maffi TR, Burr LJ, Doris PE. Abnormal cholangiograms during laparoscopic cholecystectomy. Is treatment always necessary? Surg Endosc. 1997 May;11(5):456–9CrossRef

12.

Gupta N. Role of laparoscopic common bile duct exploration in the management of choledocholithiasis. World J Gastrointest Surg. 2016 May 27;8(5):376–81CrossRef

13.

Working Group IAP/APA Acute Pancreatitis Guidelines. IAP/APA evidence-basedguidelines for the management of acute pancreatitis. Pancreatology. 2013 Jul-Aug;13(4 Suppl 2):e1–15

14.

Berci G, Morgenstern L, Paz-Partlow M. The impact of electronic imaging inintraoperative biliary endoscopy (choledochoscopy). Surg Endosc.1988;2(3):167–71CrossRef

15.

Paganini AM, Guerrieri M, Sarnari J, De Sanctis A, D'Ambrosio G, Lezoche G, Perretta S, Lezoche E. Thirteen years’ experience with laparoscopic transcystic common bile duct exploration for stones. Effectiveness and long-term results. Surg Endosc. 2007 Jan;21(1):34–40CrossRef

16.

March B, Burnett D, Gani J. Single-stage laparoscopic cholecystectomy and intraoperative endoscopic retrograde cholangiopancreatography: is this strategy feasible in Australia? ANZ J Surg. 2016 Nov;86(11):874–877CrossRef

17.

Swahn F, Regnér S, Enochsson L, Lundell L, Permert J, Nilsson M, Thorlacius H, Arnelo U. Endoscopic retrograde cholangiopancreatography with rendezvous cannulation reduces pancreatic injury. World J Gastroenterol. 2013 Sep 28;19(36):6026–34CrossRef

18.

Telem DA, Pauli EM. (2015) Gallstones and Common Bile Duct Stones in the Bariatric Surgery Patient: Surgical and Endoscopic Management. Bariatric Surgery Complications and Emergencies. Herron DM (Ed.) New York, NY: Springer)

19.

Cavina E, Franceschi M, Sidoti F, Goletti O, Buccianti P, Chiarugi M. Laparo-endoscopic “rendezvous”: a new technique in the choledocholithiasis treatment. Hepatogastroenterology. 1998 Sep-Oct;45(23):1430–5PubMed

20.

Coelho-Prabhu N, Shah ND, Van Houten H, Kamath PS, Baron TH. Endoscopic retrograde cholangiopancreatography: utilisation and outcomes in a 10-year population-based cohort. BMJ Open. 2013 May 31;3(5)

21.

Tse F, Yuan Y. Early Routine Endoscopic Retrograde Cholangiopancreatography Strategy Versus Early Conservative Management Strategy in Acute Gallstone Pancreatitis. Cochrane Database Syst Rev. 2012 May 16;(5)

22.

Passi M, Inamdar S, Hersch D, Dowling O, Sejpal DV, Trindade AJ. Inpatient Choledocholithiasis Requiring ERCP and Cholecystectomy: Outcomes of a Combined Single Inpatient Procedure Versus Separate-Session Procedures. J Gastrointest Surg. 2017 Oct 2

23.

Elgeidie A, Atif E, Elebidy G. Intraoperative ERCP for management of cholecystocholedocholithiasis. Surg Endosc. 2017 Feb;31(2):809–816CrossRef

24.

Mallick R, Rank K, Ronstrom C, Amateau SK, Arain M, Attam R, Freeman ML, Harmon JV. Single-session laparoscopic cholecystectomy and ERCP: a valid option for the management of choledocholithiasis. Gastrointest Endosc. 2016 Oct;84(4):639–45CrossRef

25.

Yamamoto, H; Sekine, Y; Sato, Y; Higashizawa, T; Miyata, T; Iino, S; Ido, K; Sugano, K. Total enteroscopy with a nonsurgical steerable double-balloon method. Gastrointestinal Endoscopy, 2001, 53(2), 216–20.CrossRef

26.

Baron, TH. Double-balloon enteroscopy to facilitate retrograde PEG placement as access for therapeutic ERCP in patients with long-limb gastric bypass. Gastrointest Endosc. 2006, 64, 973–4CrossRef

27.

Ross, AS; Semrad, C; Alverdy, J; et al. Use of double-balloon enteroscopy to perform PEG in the excluded stomach after Roux-en-Y gastric bypass. Gastrointest Endosc., 2006, 64, 797–800.CrossRef

28.

Ross, AS; Dye, C. Double-balloon enteroscopy to facilitate retrograde PEG placement as access for therapeutic ERCP in patients with long-limb gastric bypass. Gastrointest Endosc., 2007, 66(2), 419.CrossRef

29.

Sakai, P; Kuga, R; Safatle-Ribeiro, AV; Faintuch, J; Gama-Rodrigues, JJ; Ishida, RK; Furuya, CK; Jr. Yamamoto, H; Ishioka, S. Is it feasible to reach the bypassed stomach after Roux-en-Y gastric bypass for morbid obesity? The use of the double-balloon enteroscope. Endoscopy., 2005, 37(6), 566–9.

30.

Schreiner MA, Chang L, Gluck M, Irani S, Gan SI, Brandabur JJ, Thirlby R,Moonka R, Kozarek RA, Ross AS. Laparoscopy-assisted versus balloonenteroscopy-assisted ERCP in bariatric post-Roux-en-Y gastric bypass patients.Gastrointest Endosc. 2012 Apr;75(4):748–56CrossRef

31.

Baron TH, Song LM. Percutaneous Assisted Transprosthetic Endoscopic Therapy (PATENT): Expanding Gut Access to Infinity and Beyond! Gastrointest Endosc. 2012 Sep;76(3):641–4CrossRef

32.

Cremer A, Arvanitakis M. Diagnosis and management of bile stone disease and its complications. Minerva Gastroenterol Dietol. 2016 Mar;62(1):103–29PubMed

33.

Classen M, Demling L. Steinextraktion aus dem Gallengang endoskopisch möglich. Med Trib. 1973;27:1–5

34.

Mayumi T, Okamoto K, Takada T, Strasberg SM, Solomkin JS, Schlossberg D, Pitt HA, Yoshida M, Gomi H, Miura F, Garden OJ, Kiriyama S, Yokoe M, Endo I, Asbun HJ, Iwashita Y, Hibi T, Umezawa A, Suzuki K, Itoi T, Hata J, Han HS, Hwang TL, Dervenis C, Asai K, Mori Y, Huang WS, Belli G, Mukai S, Jagannath P, Cherqui D, Kozaka K, Baron TH, de Santibañes E, Higuchi R, Wada K, Gouma DJ, Deziel DJ, LiauKH, Wakabayashi G, Padbury R, Jonas E, Supe AN, Singh H, Gabata T, Chan ACW, Lau WY, Fan ST, Chen MF, Ker CG, Yoon YS, Choi IS, Kim MH, Yoon DS, Kitano S, Inomata M, Hirata K, Inui K, Sumiyama Y, Yamamoto M. Tokyo Guidelines 2018: management bundles for acute cholangitis and cholecystitis. J Hepatobiliary Pancreat Sci. 2018 Jan;25(1):96–100

35.

Mohammad Alizadeh AH. Cholangitis: Diagnosis, Treatment and Prognosis. J Clin Transl Hepatol. 2017 Dec 28;5(4):404–413PubMedPubMedCentral

36.

Hou LA, Laine L, Motamedi N, Sahakian A, Lane C, Buxbaum J. Optimal Timing of Endoscopic Retrograde Cholangiopancreatography in Acute Cholangitis. J Clin Gastroenterol. 2017 Jul;51(6):534–538CrossRef

37.

Besselink MG, van Santvoort HC, Nieuwenhuijs VB, Boermeester MA, Bollen TL, Buskens E, Dejong CH, van Eijck CH, van Goor H, Hofker SS, Lameris JS, van Leeuwen MS, Ploeg RJ, van Ramshorst B, Schaapherder AF, Cuesta MA, Consten EC, Gouma DJ, van der Harst E, Hesselink EJ, Houdijk LP, Karsten TM, van Laarhoven CJ, Pierie JP, Rosman C, Bilgen EJ, Timmer R, van der Tweel I, de Wit RJ, Witteman BJ, Gooszen HG; Dutch Acute Pancreatitis Study Group. Minimally invasive ‘step-up approach’ versus maximal necrosectomy in patients with acute necrotisingpancreatitis (PANTER trial): design and rationale of a randomised controlledmulticenter trial [ISRCTN13975868]. BMC Surg. 2006 Apr 11;6:6CrossRef

38.

van Santvoort HC, Besselink MG, Bakker OJ, Hofker HS, Boermeester MA, Dejon CH, van Goor H, Schaapherder AF, van Eijck CH, Bollen TL, van Ramshorst B, Nieuwenhuijs VB, Timmer R, Laméris JS, Kruyt PM, Manusama ER, van der Harst E, van der Schelling GP, Karsten T, Hesselink EJ, van Laarhoven CJ, Rosman C, Bosscha K, de Wit RJ, Houdijk AP, van Leeuwen MS, Buskens E, Gooszen HG; DutchPancreatitis Study Group. A step-up approach or open necrosectomy for necrotizingpancreatitis. N Engl J Med. 2010 Apr 22;362(16):1491–502CrossRef

39.

van Brunschot S, van Grinsven J, van Santvoort HC, Bakker OJ, Besselink MG, Boermeester MA, Bollen TL, Bosscha K, Bouwense SA, Bruno MJ, Cappendijk VC, Consten EC, Dejong CH, van Eijck CH, Erkelens WG, van Goor H, van Grevenstein WMU, Haveman JW, Hofker SH, Jansen JM, Laméris JS, van Lienden KP, Meijssen MA, Mulder CJ, Nieuwenhuijs VB, Poley JW, Quispel R, de Ridder RJ, Römkens TE, Scheepers JJ, Schepers NJ, Schwartz MP, Seerden T, Spanier BWM, Straathof JWA, Strijker M, Timmer R, Venneman NG, Vleggaar FP, Voermans RP, Witteman BJ, Gooszen HG, Dijkgraaf MG, Fockens P; Dutch Pancreatitis Study Group. Endoscopic orsurgical step-up approach for infected necrotising pancreatitis: a multicentrerandomised trial. Lancet. 2018Jan 6 ;391(10115):51–58CrossRef

40.

ASGE Standards of Practice Committee, Muthusamy VR, Chandrasekhara V, Acosta RD, Bruining DH, Chathadi KV, Eloubeidi MA, Faulx AL, Fonkalsrud L, Gurudu SR, Khashab MA, Kothari S, Lightdale JR, Pasha SF, Saltzman JR, Shaukat A, Wang A, Yang J, Cash BD, DeWitt JM. The role of endoscopy in the diagnosis and treatment of inflammatory pancreatic fluid collections. Gastrointest Endosc. 2016 Mar;83(3):481–8CrossRef

41.

van Brunschot S, Bakker OJ, Besselink MG, Bollen TL, Fockens P, Gooszen HG, van Santvoort HC; Dutch Pancreatitis Study Group. Treatment of necrotizing pancreatitis. Clin Gastroenterol Hepatol. 2012 Nov;10(11):1190–201CrossRef

42.

Voermans RP, Besselink MG, Fockens P. Endoscopic management of walled-off pancreatic necrosis. J Hepatobiliary Pancreat Sci. 2015 Jan;22(1):20–6CrossRef

43.

Bang JY, Wilcox CM, Trevino J, Ramesh J, Peter S, Hasan M, Hawes RH,Varadarajulu S. Factors impacting treatment outcomes in the endoscopic managementof walled-off pancreatic necrosis. J Gastroenterol Hepatol. 2013 Nov;28(11):1725–32CrossRef

44.

Yasuda I, Nakashima M, Iwai T, Isayama H, Itoi T, Hisai H, Inoue H, Kato H,Kanno A, Kubota K, Irisawa A, Igarashi H, Okabe Y, Kitano M, Kawakami H, Hayashi T, Mukai T, Sata N, Kida M, Shimosegawa T. Japanese multicenter experience ofendoscopic necrosectomy for infected walled-off pancreatic necrosis: The JENIPaN study. Endoscopy. 2013 Aug;45(8):627–34CrossRef

45.

Seifert H, Biermer M, Schmitt W, Jürgensen C, Will U, Gerlach R, Kreitmair C, Meining A, Wehrmann T, Rösch T. Transluminal endoscopic necrosectomy after acute pancreatitis: a multicentre study with long-term follow-up (the GEPARD Study).Gut. 2009 Sep;58(9):1260–6CrossRef

46.

van Brunschot S, Fockens P, Bakker OJ, Besselink MG, Voermans RP, Poley JW,Gooszen HG, Bruno M, van Santvoort HC. Endoscopic transluminal necrosectomy in necrotising pancreatitis: a systematic review. Surg Endosc. 2014 May;28(5):1425–38CrossRef

47.

Siddiqui AA, Easler J, Strongin A, Slivka A, Kowalski TE, Muddana V, Chennat J, Baron TH, Loren DE, Papachristou GI. Hydrogen peroxide-assisted endoscopic necrosectomy for walled-off pancreatic necrosis: a dual center pilot experience. Dig Dis Sci. 2014 Mar;59(3):687–90

48.

Abdelhafez M, Elnegouly M, Hasab Allah MS, Elshazli M, Mikhail HM, Yosry A.Transluminal retroperitoneal endoscopic necrosectomy with the use of hydrogen peroxide and without external irrigation: a novel approach for the treatment of walled-off pancreatic necrosis. Surg Endosc. 2013 Oct;27(10):3911–20CrossRef

49.

Mui LM, Wong SK, Ng EK, Chan AC, Chung SC. Combined sinus tract endoscopy and endoscopic retrograde cholangiopancreatography in management of pancreatic necrosis and abscess. Surg Endosc. 2005 Mar;19(3):393–7CrossRef

50.

Pannala R, Ross AS. Pancreatic endotherapy and necrosectomy. Curr Treat Options Gastroenterol. 2015 Jun;13(2):185–97CrossRef

51.

Jabłońska B. Hepatectomy for bile duct injuries: when is it necessary? World J Gastroenterol. 2013 Oct 14;19(38):6348–52CrossRef

52.

Eum YO, Park JK, Chun J, Lee SH, Ryu JK, Kim YT, Yoon YB, Yoon CJ, Han HS,Hwang JH. Non-surgical treatment of post-surgical bile duct injury: clinicalimplications and outcomes. World J Gastroenterol. 2014 Jun 14;20(22):6924–31CrossRef

53.

Trondsen E, Ruud TE, Nilsen BH, Mårvik R, Myrvold HE, Buanes T, Viste A, Jørgensen PF, Jacobsen T, Rosseland AR. Complications during the introduction of laparoscopic cholecystectomy in Norway. A prospective multicentre study in seven hospitals. Eur J Surg. 1994 Mar;160(3):145–51PubMed

54.

Brugge WR, Rosenberg DJ, Alavi A. Diagnosis of postoperative bile leaks. Am J Gastroenterol. 1994 Dec;89(12):2178–83PubMed

55.

Bourke, MJ et al. Endoscopic management of post-operative bile leak (EMBL) in 85 patients. Gastrointestinal Endoscopy, Volume 41 , Issue 4 , 390

56.

Kahaleh M, Sundaram V, Condron SL, De La Rue SA, Hall JD, Tokar J, Friel CM, Foley EF, Adams RB, Yeaton P. Temporary placement of covered self-expandable metallic stents in patients with biliary leak: midterm evaluation of a pilot study. Gastrointest Endosc. 2007 Jul;66(1):52–9CrossRef

57.

Dave S, London S. (2017) Trauma, Pancreatic. Retrieved from StatPearls Treasure Island (FL): https://www.statpearls.com/

58.

Ho VP, Patel NJ, Bokhari F, Madbak FG, Hambley JE, Yon JR, Robinson BR, Nagy K, Armen SB, Kingsley S, Gupta S, Starr FL, Moore HR 3rd, Oliphant UJ, Haut ER, Como JJ. Management of adult pancreatic injuries: A practice management guideline from the Eastern Association for the Surgery of Trauma. J Trauma Acute Care Surg. 2017 Jan;82(1):185–199CrossRef

59.

Rekhi S, Anderson SW, Rhea JT, Soto JA. Imaging of blunt pancreatic trauma. Emerg Radiol. 2010 Jan;17(1):13–9CrossRef

60.

Rosenfeld EH, Vogel AM, Klinkner DB, Escobar M, Gaines B, Russell R, Campbell B, Wills H, Stallion A, Juang D, Thakkar RK, Upperman J, Jafri M, Burd R, Naik-Mathuria BJ; Pancreatic Trauma Study Group. The utility of ERCP in pediatric pancreatic trauma. J Pediatr Surg. 2017 Oct 13

61.

Mutignani M, Dokas S, Tringali A, Forti E, Pugliese F, Cintolo M, Manta R, Dioscoridi L. Pancreatic Leaks and Fistulae: An Endoscopy-Oriented Classification. Dig Dis Sci. 2017 Oct;62(10):2648–2657CrossRef

62.

Lu P, Chan CL, Yang NP, Chang NT, Lin KB, Lai KR. Outcome comparison between percutaneous cholecystostomy and cholecystectomy: a 10-year population-based analysis. BMC Surg. 2017 Dec 7;17(1):130CrossRef

63.

La Greca A, Di Grezia M, Magalini S, Di Giorgio A, Lodoli C, Di Flumeri G, Cozza V, Pepe G, Foco M, Bossola M, Gui D. Comparison of cholecystectomy and percutaneous cholecystostomy in acute cholecystitis: results of a retrospective study. Eur Rev Med Pharmacol Sci. 2017 Oct;21(20):4668–4674PubMed

64.

Hall BR, Armijo PR, Krause C, Burnett T, Oleynikov D. Emergent cholecystectomy is superior to percutaneous cholecystostomy tube placement in critically ill patients with emergent calculous cholecystitis. Am J Surg. 2017 Nov 3. pii: S0002–9610(17)31251–5

65.

Goode, S.D. et al. Stenting of the cystic duct: a possible bridge to laparoscopic cholecystectomy? Journal of Vascular and Interventional Radiology Volume 24 , Issue 4 , S55

66.

Maekawa S, Nomura R, Murase T, Ann Y, Oeholm M, Harada M. Endoscopic gallbladder stenting for acute cholecystitis: a retrospective study of 46 elderly patients aged 65 years or older. BMC Gastroenterol. 2013 Apr 12;13:65CrossRef

67.

Lee TH, Park DH, Lee SS, Seo DW, Park SH, Lee SK, Kim MH, Kim SJ. Outcomes of endoscopic transpapillary gallbladder stenting for symptomatic gallbladder diseases: a multicenter prospective follow-up study. Endoscopy. 2011 Aug;43(8):702–8CrossRef

68.

Patil R, Ona MA, Papafragkakis C, Anand S, Duddempudi S. Endoscopic ultrasound-guided placement of the lumen-apposing self-expandable metallic stent for gallbladder drainage: a promising technique. Ann Gastroenterol. 2016 Apr-Jun;29(2):162–7PubMedPubMedCentral

69.

Hatanaka T, Itoi T, Ijima M, Matsui A, Kurihara E, Okuno N, Kobatake T, Kakizaki S, Yamada M. Efficacy and Safety of Endoscopic Gallbladder Stenting for Acute Cholecystitis in Patients with Concomitant Unresectable Cancer. Intern Med. 2016;55(11):1411–7CrossRef

70.

Kunda R, Pérez-Miranda M, Will U, Ullrich S, Brenke D, Dollhopf M, Meier M, Larghi A. EUS-guided choledochoduodenostomy for malignant distal biliary obstruction using a lumen-apposing fully covered metal stent after failed ERCP. Surg Endosc. 2016 Nov;30(11):5002–5008CrossRef

71.

Barbera C, Grande G, Alberghina N, Manno M, Conigliaro RL. Single-step endoscopic ultrasound-guided fluoroless gallbladder drainage using the Axios lumen-apposing metal stent. Endoscopy. 2016;48

72.

Chan JHY, Teoh AYB. Current Status of Endoscopic Gallbladder Drainage. Clin Endosc. 2017 Nov 17

73.

Kamata K, Takenaka M, Kitano M, Omoto S, Miyata T, Minaga K, Yamao K, Imai H, Sakurai T, Watanabe T, Nishida N, Kudo M. Endoscopic ultrasound-guided gallbladder drainage for acute cholecystitis: Long-term outcomes after removal of a self-expandable metal stent. World J Gastroenterol. 2017 Jan 28;23(4):661–667CrossRef

74.

Anderloni A, Buda A, Vieceli F, Khashab MA, Hassan C, Repici A. Endoscopic ultrasound-guided transmural stenting for gallbladder drainage in high-risk patients with acute cholecystitis: a systematic review and pooled analysis. Surg Endosc. 2016 Dec;30(12):5200–5208CrossRef

75.

Talukdar R. Complications of ERCP. Best Pract Res Clin Gastroenterol. 2016 Oct;30(5):793–805CrossRef

76.

Chen JJ, Wang XM, Liu XQ, Li W, Dong M, Suo ZW, Ding P, Li Y. Risk factors for post-ERCP pancreatitis: a systematic review of clinical trials with a large sample size in the past 10 years. Eur J Med Res. 2014 May 15;19:26CrossRef

77.

Fan JH, Qian JB, Wang YM, Shi RH, Zhao CJ. Updated meta-analysis of pancreatic stent placement in preventing post-endoscopic retrograde cholangiopancreatography pancreatitis. World J Gastroenterol. 2015 Jun 28;21(24):7577–83CrossRef

78.

Iwasaki E, Itoi T, Kanai T. Metal stent for refractory post-ES bleeding: Is this the ultimate treatment modality? Endoscopy International Open. 2016;4(12):E1265-E1266CrossRef

79.

Stapfer M, Selby RR, Stain SC, Katkhouda N, Parekh D, Jabbour N, Garry D. Management of duodenal perforation after endoscopic retrograde cholangiopancreatography and sphincterotomy. Ann Surg. 2000 Aug;232(2):191–8CrossRef

80.

Chung JW, Chung JB. Endoscopic papillary balloon dilation for removal of choledocholithiasis: indications, advantages, complications, and long-term follow-up results. Gut Liver. 2011 Mar;5(1):1–14CrossRef

81.

Avgerinos DV, Llaguna OH, Lo AY, Voli J, Leitman IM. Management of endoscopic retrograde cholangiopancreatography: related duodenal perforations. Surg Endosc. 2009 Apr;23(4):833–8CrossRef

82.

Genzlinger JL, McPhee MS, Fisher JK, Jacob KM, Helzberg JH. Significance of retroperitoneal air after endoscopic retrograde cholangiopancreatography with sphincterotomy. Am J Gastroenterol. 1999 May;94(5):1267–70CrossRef

83.

Beilenhoff U, Biering H, Blum R, Brljak J, Cimbro M, Dumonceau JM, Hassan C, Jung M, Neumann C, Pietsch M, Pineau L, Ponchon T, Rejchrt S, Rey JF, Schmidt V, Tillett J, van Hooft J. Prevention of multidrug-resistant infections from contaminated duodenoscopes: Position Statement of the European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastroenterology Nurses and Associates (ESGENA). Endoscopy. 2017 Nov;49(11):1098–1106CrossRef

Titel: Endoscopic Management of Acute Biliopancreatic Disorders
verfasst von: Ryan M. Juza
Eric M. Pauli
Publikationsdatum: 28.02.2019
Verlag: Springer US
Erschienen in: Journal of Gastrointestinal Surgery / Ausgabe 5/2019
Print ISSN: 1091-255X
Elektronische ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-019-04143-x

Neu im Fachgebiet Chirurgie

Echinokokkose medikamentös behandeln oder operieren?

06.05.2024 DCK 2024 Kongressbericht

Die Therapie von Echinokokkosen sollte immer in spezialisierten Zentren erfolgen. Eine symptomlose Echinokokkose kann – egal ob von Hunde- oder Fuchsbandwurm ausgelöst – konservativ erfolgen. Wenn eine Op. nötig ist, kann es sinnvoll sein, vorher Zysten zu leeren und zu desinfizieren.

Wie sieht der OP der Zukunft aus?

04.05.2024 DCK 2024 Kongressbericht

Der OP in der Zukunft wird mit weniger Personal auskommen – nicht, weil die Technik das medizinische Fachpersonal verdrängt, sondern weil der Personalmangel es nötig macht.

Umsetzung der POMGAT-Leitlinie läuft

03.05.2024 DCK 2024 Kongressbericht

Seit November 2023 gibt es evidenzbasierte Empfehlungen zum perioperativen Management bei gastrointestinalen Tumoren (POMGAT) auf S3-Niveau. Vieles wird schon entsprechend der Empfehlungen durchgeführt. Wo es im Alltag noch hapert, zeigt eine Umfrage in einem Klinikverbund.

Recycling im OP – möglich, aber teuer

02.05.2024 DCK 2024 Kongressbericht

Auch wenn sich Krankenhäuser nachhaltig und grün geben – sie tragen aktuell erheblich zu den CO₂-Emissionen bei und produzieren jede Menge Müll. Ein Pilotprojekt aus Bonn zeigt, dass viele Op.-Abfälle wiederverwertet werden können.

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Aktuelle BDC Leitlinien-Webinare

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare

CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare

CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske

Dr. med. Benjamin Meyknecht

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare

CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric

Springer Medizin

Abstract

Purpose

Methods

Results

Discussion

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 5/2019

Laparoscopic Surgery for Diverticular Fistulas: Outcomes of 111 Consecutive Cases at a Single Institution

A Preoperative Prognostic Scoring System to Predict Prognosis for Resectable Pancreatic Cancer: Who Will Benefit from Upfront Surgery?

Volumetric and Functional Regeneration of Remnant Liver after Hepatectomy

Circulating Leptin and Branched Chain Amino Acids—Correlation with Intraductal Papillary Mucinous Neoplasm Dysplastic Grade

Superior Mesenteric Artery Syndrome: a Prospective Study in a Single Institution

Is Resection of Primary Midgut Neuroendocrine Tumors in Patients with Unresectable Metastatic Liver Disease Justified? A Systematic Review and Meta-Analysis

Update Chirurgie