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[PMID]: 29523291
[Au] Autor:Zitinic I; Plavsic I; Poropat G; Hauser G
[Ad] Address:Centre for Emergency Medicine, Clinical Hospital Centre, Rijeka, Croatia.
[Ti] Title:ERCP induced and non-ERCP-induced acute pancreatitis: Two distinct clinical entities?
[So] Source:Med Hypotheses;113:42-44, 2018 Apr.
[Is] ISSN:1532-2777
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Acute pancreatitis (AP) is a common gastrointestinal disease of varied etiology; however, the most common causes of AP are gallstones and alcohol abuse. AP has emerged as the most frequent complication after endoscopic retrograde cholangiopancreatography (ERCP). Post-ERCP pancreatitis is generally a clinically irrelevant condition; however, it can be severe or even fatal in up to 0.8% of cases. Different clinical courses and outcomes have been observed between mild and severe AP of different etiologies (i.e., non-ERCP AP and post-ERCP AP), which opens the discussion as to whether they are the same or distinct clinical entities.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:In-Process

  2 / 16981 MEDLINE  
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[PMID]: 29519608
[Au] Autor:Schneider R; Lazaridis I; Kraljevic M; Beglinger C; Wölnerhanssen B; Peterli R
[Ad] Address:Department of Surgery, St. Claraspital AG, Basel, Switzerland. Electronic address: romano.schneider@claraspital.ch.
[Ti] Title:The impact of preoperative investigations on the management of bariatric patients; results of a cohort of more than 1200 cases.
[So] Source:Surg Obes Relat Dis;, 2018 Jan 12.
[Is] ISSN:1878-7533
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Despite the increasing use of bariatric surgery as the most effective treatment of morbid obesity, there is still no consensus on its preoperative diagnostic workup. The aim of this study was to identify the pathologies of the endoscopic and radiologic investigations before performing bariatric surgery and to evaluate their impact on the patient management. METHODS: Retrospective analysis of prospectively collected data of 1225 consecutive patients who underwent laparoscopic Roux-en-Y gastric bypass (n = 834) or sleeve gastrectomy (n = 391) at our institution. An abdominal ultrasound was performed in 1188 patients, 1190 patients underwent upper gastrointestinal (GI) endoscopy, 1178 patients underwent upper GI series, and 610 patients underwent esophageal manometry. SETTING: Private hospital, Switzerland. RESULTS: Gallstones were detected in 222 (21.0%) patients, and a synchronous cholecystectomy was performed in 220 (18.0%) patients. The upper GI series indicated hiatal hernias in 325 (27.6%) patients. The most common findings of the upper GI endoscopy were type-C gastritis (224 patients, 18.8%), reflux esophagitis (229 patients, 19.2%), Helicobacter pylori-positive gastritis (158, 13.3%), and hiatal hernia (55 patients, 4.6%). Additionally, we detected 1 Barrett's high-grade dysplasia, 2 Barrett's carcinomas, and 1 stomach cancer in asymptomatic patients, who were scheduled to have a sleeve gastrectomy. Esophageal motility disorders were detected in 104 (17.0%) individuals, who underwent esophageal manometry. CONCLUSIONS: We recommend performing abdominal sonography and upper GI endoscopy before bariatric surgery as they reveal findings, which influence the therapeutic approach. Upper GI series and esophageal manometry help to define patients not suitable for sleeve gastrectomy.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher

  3 / 16981 MEDLINE  
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[PMID]: 29192385
[Au] Autor:Somasekar K; Chan DSY; Sreekumar NS; Anwer S
[Ad] Address:Department of General Surgery, Nevill Hall Hospital, Brecon Road, Abergavenny, Wales, NP7 7EG, UK.
[Ti] Title:Choledocholithiasis after Bariatric Surgery-More than a Stone's Throw to Reach?
[So] Source:J Gastrointest Surg;22(3):529-537, 2018 Mar.
[Is] ISSN:1873-4626
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Gallstone disease is common after bariatric surgery, and patients with bile duct stones in this cohort can be difficult to treat, due to the altered anatomy. This review aims to analyse the various management options available for choledocholithiasis in post-bariatric surgery patients. METHODS: A literature search of PubMed, Medline and Cochrane library databases was carried out for studies on this subject, between January 1970 and March 2017. After initial screening and further full text review, suitable studies were identified after applying the inclusion criteria. RESULTS: Twenty-nine studies were identified and analysed. Overtube-assisted endoscopy appears to be a popular technique, and 10 studies employing this technique were identified. Though there are minor variations between the three different types of overtube endoscopy, the success rate for ERCP with this approach is between 60 and 70%. Studies using a combination of radiological and endoscopic techniques report a success rate of 60-70%, though the endoscopic ultrasound-guided technique has been reported to have higher success rates (90-100%). Surgery-assisted ERCP also appears to be widely reported and has a consistently high ERCP success rate (80-100%), with an added advantage of the option to perform a concomitant cholecystectomy. There are very few reports on using surgery as the sole option in this scenario. CONCLUSION: Both overtube-assisted endoscopy and laparoscopy-assisted ERCP appear to be safe, with good success rates. The other methods may be suitable for selected patients and centres with specific interest in such techniques.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:In-Data-Review
[do] DOI:10.1007/s11605-017-3634-4

  4 / 16981 MEDLINE  
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[PMID]: 29512023
[Au] Autor:Kalaria R; Abraham P; Desai DC; Joshi A; Gupta T
[Ad] Address:Division of Gastroenterology, P D Hinduja Hospital and Medical Research Centre, Veer Savarkar Marg, Mahim, Mumbai, 400 016, India.
[Ti] Title:Rate of recurrence in Indian patients presenting with acute pancreatitis and identification of chronicity on follow up: Possible risk factors for progression.
[So] Source:Indian J Gastroenterol;, 2018 Mar 07.
[Is] ISSN:0975-0711
[Cp] Country of publication:India
[La] Language:eng
[Ab] Abstract:BACKGROUND: To study the profile and long-term outcome of Indian patients presenting with acute pancreatitis and the possible risk factors for progression. METHODS: Consecutive patients with acute or recurrent acute pancreatitis seen in our department during July 2013 to December 2014 were included. Details of past episodes were collected and patients were followed up till March 2015. RESULTS: In the 97 patients included (mean age 47.2 [SD 16.9] years; 74 men), gallstones (37 [38.1%]) and alcohol (19 [19.6%]) were the major identified etiologies; the idiopathic (31 [32%]) group constituted a third of patients. Recurrences were more common with idiopathic etiology (14 patients out of 30 had recurrences [46.7%]) as compared to alcoholic (5 out of 19 [26.3%]) and biliary (4 out of 37 [10.8%]) pancreatitis and with mild index episode. Following the episode of acute pancreatitis, identification of chronic pancreatitis was more common with alcoholic (6 out of 18 [33%]) and idiopathic (9 out of 30 [30%]) etiology as compared to other etiologies. Longer duration of follow up, but not number of recurrent episodes, was associated with identification of chronicity in patients presenting as acute pancreatitis. CONCLUSIONS: Out of 97 patients with acute pancreatitis, 27 (27.8%) developed recurrences with risk factors being idiopathic etiology and mild index episode. Eighteen of 97 (18.6%) patients had evidence of chronic pancreatitis on follow up, risk factors being the alcoholic and idiopathic varieties, and longer duration of follow up.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180307
[Lr] Last revision date:180307
[St] Status:Publisher
[do] DOI:10.1007/s12664-018-0818-0

  5 / 16981 MEDLINE  
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[PMID]: 29421933
[Au] Autor:Vaynshtein J; Sabbag G; Pinsk I; Rahmani I; Reshef A
[Ad] Address:a Department of surgery , Soroka university medical center , Beer Sheva , Israel.
[Ti] Title:Predictors for choledocholitiasis in patients undergoing endoscopic ultrasound.
[So] Source:Scand J Gastroenterol;53(3):335-339, 2018 Mar.
[Is] ISSN:1502-7708
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:AIM: Biliary lithiasis is common in most western countries. Symptomatic patients will also have choledocholithiasis in 10% of the cases. For patients with intermediate probability of CBD stones, the recommended imaging studies are endoscopic ultrasound (EUS) or MRCP. This study aims to identify early factors that can be used as predictors for the presence of CBD stones, and by that to find which patient should undergo ERCP without an early EUS. METHODS: This is a retrospective cohort study including all patients who underwent EUS for suspected choledocholithiasis at the Soroka University Medical Center (SUMC) in the years 2009-2014. Data collection was performed by manual surveillance of patients' computerized files and data gathering after approval by the Soroka Institutional Review Board Results: One hundred seventy-five (175) patients were included in the study. The average age was 57, and 111 patients were women (64.2%). Sixty-two patients (35%) had common bile duct stones by EUS and underwent an ERCP. Eighty-two percent of those 62 patients were found to have CBD stones at ERCP. Patients found positive for CBD stones by EUS were older than those who were negative (52 vs. 71 respectively, p < .001). These patients were also found to have a higher prevalence of ischemic heart disease and congestive heart failure. Common bile duct dilatation ≥8mm and gallstones presence in abdominal ultrasonography were more common in patients found positive for CBD stones by EUS than in those who were found negative (45% vs. 24% p < .05, and 81% vs. 66% p < .05, respectively). Alkaline phosphatase (ALP) serum levels higher than 300 IU/L were found to be the only independent predictor for the existence of CBD stones (OR = 2.98, p = .001(. When ALP serum levels lower than 150 IU/L or GGT lower than 150 IU/L were measured, the probability of having CBD stones was low (NPV of 90% and 87%, respectively). CONCLUSIONS: ALP serum levels higher than 300 IU/L are an independent predictor for the presence of CBD stones. EUS is an excellent screening tool for choledocholithiasis before performing ERCP. In most patients who undergo an early EUS, a subsequent diagnostic ERCP will not be needed.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180307
[Lr] Last revision date:180307
[St] Status:In-Data-Review
[do] DOI:10.1080/00365521.2018.1435716

  6 / 16981 MEDLINE  
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[PMID]: 29480862
[Au] Autor:Yao BZ; Li L; Jiang M; Wang J; Zhang J
[Ti] Title:Refractory chyle leakage after laparoscopic cholecystectomy for gallstone disease: A case report and literature review.
[So] Source:Medicine (Baltimore);97(2):e9604, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:RATIONALE: Gallstone disease is commonly worldwide and safely treated by laparoscopic cholecystectomy. Chylous ascites is a rare but serious complication of many abdominal operations. PATIENT CONCERNS: We present a rare case of refractory chyle leakage post-LC for acute cholecystitis that is successfully treated in a 40-year-old man, and review current literature on the prevalence, diagnosis, and management of this complication. DIAGNOSES: Refractory chyle leakage post-LC, a rare but serious complication after laparoscopic cholecystectomy. INTERVENTIONS: Conservative treatment was given initially; however, the outcome was frustrating. Surgical intervention was given without further delay. OUTCOMES: After the reoperation, conservative treatment was still maintained. After nearly 8 months of treatment, the patient recovered and then was discharged. LESSONS: This case represents a previously unreported complication of refractory and high flow chyle leakage after laparoscopic cholecystectomy, which did not improve alter conservative management with dietary changes and other measures. So we suggest that surgical intervention should be given for refractory cases without further delay. It can not only shorten the disease progression, but also alleviate the sufferings of the patient.
[Mh] MeSH terms primary: Cholecystectomy, Laparoscopic/adverse effects
Cholecystitis, Acute/surgery
Chyle
Postoperative Complications
[Mh] MeSH terms secundary: Adult
Conservative Treatment
Drainage
Gallstones/surgery
Humans
Male
Reoperation
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Entry month:1803
[Cu] Class update date: 180305
[Lr] Last revision date:180305
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:180227
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009604

  7 / 16981 MEDLINE  
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[PMID]: 29498913
[Au] Autor:Amblee A; Mohananey D; Morkos M; Basu S; Abegunde A; Ganesh M; Bhalerao N; George AM; Jain M; Fogelfeld L
[Ad] Address:From: 1 Division of Diabetes and Endocrinology, John H Stroger, Jr. Hospital of Cook County, Chicago, IL.
[Ti] Title:ACUTE PANCREATITIS IN PATIENTS WITH SEVERE HYPERTRIGLYCERIDEMIA IN A MULTIETHNIC MINORITY POPULATION.
[So] Source:Endocr Pract;, 2018 Mar 02.
[Is] ISSN:1530-891X
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVE: To investigate the prevalence and predictors of hypertriglycerdemic acute pancreatitis (HTG-AP) in a multiethnic minority population. METHODS: A retrospective cross-sectional study from 2003 to 2013 of 1157 adults with serum triglyceride (TG) level ≥ 1000 mg/dL comparing baseline characteristics and risk factors between those with and without HTG-AP. RESULTS: Mean study population age was 49.2±11.5 years; 75.6% males; 31.6% African Americans, 38.4% Hispanics, 22.7% Caucasians, 5.7% Asians and 1.6 % Pacific Islanders. Prevalence of HTG-AP was 9.2%. Patients with HTG-AP were significantly younger (41.3 vs 50.0 years, p<0.001) than those without HTG-AP. Excessive alcohol intake [Odds Ratio (OR), 3.9; 95% Confidence Interval (CI), 2.5-6.0; P<.001], gallstone disease (OR, 3.9; 95% CI, 1.4-10.8; P=.008) and TG>2000 (OR, 4.8; 95% CI, 3.1-7.4; P<.001) remained significant independent risk factors. TG for patients with HTG-AP were higher [median TG 2394 mg/dL; Interquartile range (IQR), 1152-4339 mg/dL vs median TG 1406 mg/dL; IQR, 1180.7-1876.5 mg/dL]. TG levels > 2000 mg/dL were associated with higher incidence of AP (22% vs 5%). Patients with TG levels of < 2000 mg/dL and no risk factors had prevalence of 2% compared to 33.6% with one risk factor and TG > 2000 mg/dL. Patients with HTG-AP had higher incidence of diabetic ketoacidosis at admission (7.5% vs 2.5%; P=.004). CONCLUSION: TG level ≥2000 mg/dL was associated with higher HTG-AP prevalence in ethnic minorities. Presence of excessive alcohol intake and/or gallstones further accentuated risk. ABBREVIATIONS: AP = acute pancreatitis, DM = diabetes mellitus, HbA1c = hemoglobin A1c, HIV = human immunodeficiency virus, HTG = hypertriglyceridemia, HTG-AP = hypertriglyceridemic acute pancreatitis, ROC = receiver operating characteristic.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180302
[Lr] Last revision date:180302
[St] Status:Publisher
[do] DOI:10.4158/EP-2017-0178

  8 / 16981 MEDLINE  
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[PMID]: 29465584
[Au] Autor:Fan X; He L; Khadaroo PA; Zhou D; Lin H
[Ad] Address:Department of General Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine.
[Ti] Title:Duplication of the extrahepatic bile duct: A case report and review of the literatures.
[So] Source:Medicine (Baltimore);97(8):e9953, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:RATIONALE: Duplication of the extrahepatic bile duct is an extremely rare congenital anomaly of the biliary system. PATIENT CONCERNS: A 44-year-old woman presented with a history of continuous upper abdominal pain and vomiting. DIAGNOSES: Magnetic resonance cholangiopancreatography (MRCP) disclosed diffuse dilatation of the intrahepatic and extrahepatic bile ducts. Endoscopic retrograde cholangiopancreatography (ERCP) showed the presence of two extrahepatic bile ducts with calculus at the distal end of the CBD. INTERVENTIONS: Laparoscopic cholecystectomy (LC) was performed after an ERCP. Choledochoscopy, performed during the operation, showed duplicated common bile duct and the cystic duct was seen opening at the right side of the extrahepatic duct. OUTCOMES: The patient was doing well after 6 months of follow-up. LESSONS: We reported a case of a double common duct with choledocholithiasis and gallstone. This rare anomaly may lead to cholangitis, common bile duct injury during surgery, malignancy occurrence, and should be treated with extreme care.
[Mh] MeSH terms primary: Bile Duct Diseases/congenital
Bile Ducts, Extrahepatic/abnormalities
Common Bile Duct/abnormalities
[Mh] MeSH terms secundary: Adult
Cholangiopancreatography, Endoscopic Retrograde
Cholangiopancreatography, Magnetic Resonance
Cholecystectomy, Laparoscopic
Choledocholithiasis/congenital
Female
Gallstones/congenital
Humans
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Entry month:1803
[Cu] Class update date: 180302
[Lr] Last revision date:180302
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:180222
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009953

  9 / 16981 MEDLINE  
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[PMID]: 29486713
[Au] Autor:Tsai TJ; Chan HH; Lai KH; Shih CA; Kao SS; Sun WC; Wang EM; Tsai WL; Lin KH; Yu HC; Chen WC; Wang HM; Tsay FW; Lin HS; Cheng JS; Hsu PI
[Ad] Address:Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, Republic of China.
[Ti] Title:Gallbladder function predicts subsequent biliary complications in patients with common bile duct stones after endoscopic treatment?
[So] Source:BMC Gastroenterol;18(1):32, 2018 Feb 27.
[Is] ISSN:1471-230X
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: In patients with common bile duct stones (CBDS) and intact gallbladder, further management for the gallbladder after the CBDS clearance is still controversial. The relationship between gallbladder motility and the biliary complications were seldom discussed. Our study is to predict the subsequent biliary complications by gallbladder function test using fatty meal sonography (FMS) in patients with CBDS who had been treated by endoscopic retrograde cholangiopancreatography (ERCP). METHODS: Patients with an intact gallbladder and CBDS after endoscopic clearance of bile duct were enrolled. Patients received a fatty meal sonography after liver function returned to normal. The fasting volume, residual volume, and gallbladder ejection fraction (GBEF) in FMS were measured. Relationships of patients' characteristics, gallbladder function and recurrent biliary complication were analyzed. RESULTS: From 2011 to 2014, 118 patients were enrolled; 86 patients had calculus gallbladders, and 32 patients had acalculous gallbladders. After a mean follow- up of 33 months, 23 patients had recurrent biliary complications. Among 86 patients with calculus gallbladder, 15 patients had spontaneous clearance of gallbladder stones; 14 patients received cholecystectomy due to acute cholecystitis or recurrent colic pain with smooth postoperative courses. In the follow up period, six patients died of non-biliary causes. The GBEF is significant reduced in most patients with a calculus gallbladder in spite of stone color. Calculus gallbladder, alcohol drinking and more than one sessions of initial endoscopic treatment were found to be the risk factors of recurrent biliary complication. CONCLUSIONS: Gallbladder motility function was poorer in patients with a calculus gallbladder, but it cannot predict the recurrent biliary complication. Since spontaneous clearance of gallbladder stone may occur, wait and see policy of gallbladder management after endoscopic treatment of CBDS is appropriate, but regular follow- up in those patients with risk factors for recurrence is necessary.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180228
[Lr] Last revision date:180228
[St] Status:In-Process
[do] DOI:10.1186/s12876-018-0762-6

  10 / 16981 MEDLINE  
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[PMID]: 29486665
[Au] Autor:Bowers RD; Valanejad SM; Holombo AA
[Ad] Address:1 Department of Pharmacy Practice, Campbell University College of Pharmacy and Health Sciences, Buies Creek, NC, USA.
[Ti] Title:Mirtazapine-Induced Pancreatitis-A Case Report.
[So] Source:J Pharm Pract;:897190018760645, 2018 Jan 01.
[Is] ISSN:1531-1937
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Acute pancreatitis has numerous etiologies, with the most common including gallstones, alcohol abuse, and medications such as angiotensin-converting enzyme (ACE) inhibitors, statins, and diuretics. Mirtazapine has been associated with increased serum cholesterol and serum triglyceride levels. However, few studies have reported dangerously elevated triglyceride levels resulting in acute pancreatitis. This report discusses a case of mirtazapine-induced pancreatitis in a 46-year-old African American female. The patient presented to the emergency department with pancreatitis, presumably alcohol-induced as with a prior admission, but she denied any recent alcohol use. Mirtazapine then became the suspected cause of her hypertriglyceridemia-induced pancreatitis and was discontinued. After discontinuing mirtazapine, and utilizing an insulin infusion, her triglyceride levels normalized and symptoms of pancreatitis resolved. Using the Naranjo Adverse Drug Reaction Probability Scale, a total score of 5 was calculated indicating a probable adverse drug reaction of acute pancreatitis from mirtazapine.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180228
[Lr] Last revision date:180228
[St] Status:Publisher
[do] DOI:10.1177/0897190018760645


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