Endoscopic retrograde cholangiopancreatography ERCP

EPA Eicosapentaenoic acid EpDIF Epithelial-derived inhibitory factor also known as epithelium/derived relaxant fector EPO Eosinophil peroxidase EPOR Erythropoietin receptor EPR Effector cell protease EPX Eosinophil protein X ER Endoplasmic reticulum ERCP Endoscopic retrograde cholangiopancreatography E-selectin Endothelial selectin formerly known as endothelial leucocyte adhesion molecule-1 (ELAM-1)... 

FIGURE 20-2. Algorithm for evaluation and treatment of acute pancreatitis. ERCP, endoscopic retrograde cholangiopancreatography. (From Berardi RR, Montgomery PA. Pancreatitis. In DiPiro JT, Talbert RL, Yee GC, et al, (eds.) Pharmacotherapy A Pathophysiologic Approach. 6th ed. New York McGraw-Hill 2005 726, with permission.)... 

CRNP Certified Registered Nurse Practitioner ERCP Endoscopic retrograde cholangiopancreatography... 

FIGURE 28-1. Algorithm of guidelines for evaluation and treatment of acute pancreatitis. (ERCP, endoscopic retrograde cholangiopancreatography.)... 

AIDS, acquired immune deficiency syndrome ERCP, endoscopic retrograde cholangiopancreatography. 

ERCP endoscopic retrograde cholangiopancreatography JCAHO Joint Commission on Accreditation of Healthcare Organizations... 

ERCP endoscopic retrograde cholangiopancreatography NES nasal endoscopy simulator... 

Only one study to date has been conducted on the treatment of acute pancreatitis with antioxidants. Clemens et al. (1991) were unable to show any difference in the incidence or severity of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis in a prospective, randomized, double-blind, placebo-controlled trial of allopurinol. However, Salim (1991) performed a similar trial of the effect of allopurinol and DMSO in patients with pain from recurrent pancreatitis, and found significant benefit. On the basis that depletion of antioxidants is important in the pathogenesis of chronic pancreatitis, the administration of a cocktail of antioxidants was assessed for its effect on pain in this disease. Treatment with a combination of organic selenium, d-carotene, vitamins C and E, and methionine was of benefit in the initial pilot study, and in a placebo-controlled trial (San-dilands etal., 1990 Uden et al., 1990). 

O In the Western hemisphere, acute pancreatitis is caused mainly by ethanol use/abuse and gallstones. Other common causes of acute pancreatitis include hypertriglyceridemia, endoscopic retrograde cholangiopancreatography (ERCP), and autodigestion due to early activation of pancreatic enzymes. Numerous medications have also been implicated as causes of acute pancreatitis (Table 20-1). 

Hintze, R.E., Adler, A., Veltzke, W., Abou-Rebyeh, H., Hammerstingl, R., Vo, T., Felix, R. Clinical significance of magnetic resonance cholangiopancreatography (MRCP) compared to endoscopic retrograde cholangiopancreatography (ERCP). Endoscopy 1997 29 182-187... 

Bilbao MK, Dotter CT, Lee TG, Katon RM. Complications of endoscopic retrograde cholangiopancreatography (ERCP). A study of 10,000 cases. Gastroenterology 1976 70(3) 314-20. 

Small space-occupying lesions may also be identified. Endoscopic retrograde cholangiopancreatography (ERCP) ... 

Michael was scheduled for endoscopic retrograde cholangiopancreatography (ERCP). (An ERCP involves cannulation of the common bile duct—and, if necessary, the pancreatic duct— through a tube placed through the mouth and stomach and into the upper small intestine.) With this technique, a stone can be snared in the common duct and removed to relieve an obstruction. 

Endoscopic retrograde cholangiopancreatography (ERCP) is an excellent tool that affords good visualization of the biliary ducts, and the extent of the choledochal cyst. However, in pediatric patients, and especially in the very young, it can be a challenging procedure, with an unsuccessful outcome in 5%-30% of all patients. 

In a review of 17 studies in 3618 patients of somatostatin and octreotide prophylaxis for pancreatitis during endoscopic retrograde cholangiopancreatography (ERCP), there was minimal information on adverse events, but there was one case of an allergic reaction [68 ]. 

Iatrogenic duodenal injuries are rare complications of endoscopy. Perforation rarely occurs during routine endoscopy but may result from incorrect mucosal biopsy. Duodenal perforation is much more likely to follow endoscopic retrograde cholangiopancreatography (ERCP) and sphincterotomy. The latter procedure involves a diathermy cut through the muscular sphincter of Oddi in a cranial direction. The line of the cut should ideally run in a twelve o clock direction to the papilla, and retroperitoneal perforation is much more likely to occur if there is significant deviation from this approach. The reported incidence is 0.5%-2% (Zissin et al. 2000). On CT,... 

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