Between 1989 and 2012, 484 TP-IATs were performed at the University of Minnesota and University of Minnesota Amplatz Children’s Hospital. Of these, 75 were done in children and formed the study population. Our criteria for selection of patients with CP for TP-IAT has evolved over the years and have been standardized for the last 5 years.17 (link) Currently, to qualify for TP-IAT, the patient must have had abdominal pain of > 6 months duration with impaired quality of life e.g., inability to attend school, inability to participate in ordinary activities, repeated hospitalizations, or constant need for narcotics, each coupled with failure to respond to maximal medical treatment or endoscopic pancreatic duct drainage procedures. In addition, there must be objective findings of CP, including at least one of the following: (1) pancreas calcifications on CT scan, or abnormal ERCP, or ≥ 6/9 criteria on endoscopic ultrasound( EUS); or (2) any two of following three: (1) ductal or parenchymal abnormalities on secretin stimulated magnetic resonance cholangiopancreatography (MRCP), EUS of pancreas with 6/9 criteria positive, or abnormal pancreatic function tests with peak bicarbonate < 80 mmol/L).; or (2) Histopathologic confirmed diagnosis of chronic pancreatitis from previous operations; or (3) Hereditary pancreatitis (PRSS1 gene mutation, (SPINK1 gene mutation, CFTR gene mutations), with a compatible clinical history ; or (4) History of recurrent acute pancreatitis with > 3 episodes of pain associated with imaging diagnostic of acute pancreatitis and/or elevated serum amylase or lipase 3 times normal.17 (link)The current study was approved by the University of Minnesota Institutional Review Board. Informed consent and assent were obtained from parents and patients for all patients participating in quality of life assessments.
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Procedures
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Diagnostic Procedure
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Endoscopic Retrograde Cholangiopancreatography
Endoscopic Retrograde Cholangiopancreatography
Endoscopic Retrograde Cholangiopancreatography (ERCP) is a minimally invasive procedure used to diagnose and treat conditions affecting the bile and pancreatic ducts.
During ERCP, a flexible endoscope is inserted through the mouth, down the esophagus, and into the small intestine, allowing access to the bile and pancreatic ducts.
This procedure enables the visualization, diagnosis, and treatment of various disorders, such as gallstones, bile duct strictures, and pancreatic diseases.
ERCP is a complex technique that requires specialized training and expertise to perform safely and effectively, with the potential for serious complications.
Optimizing ERCP protocols and techniques is crucial for enhancing medical research and improving patient outcomes.
During ERCP, a flexible endoscope is inserted through the mouth, down the esophagus, and into the small intestine, allowing access to the bile and pancreatic ducts.
This procedure enables the visualization, diagnosis, and treatment of various disorders, such as gallstones, bile duct strictures, and pancreatic diseases.
ERCP is a complex technique that requires specialized training and expertise to perform safely and effectively, with the potential for serious complications.
Optimizing ERCP protocols and techniques is crucial for enhancing medical research and improving patient outcomes.
Most cited protocols related to «Endoscopic Retrograde Cholangiopancreatography»
Abdominal Pain
Acidic Pancreatic Trypsin Inhibitor
Bicarbonates
Child
Cholangiopancreatography, Magnetic Resonance
Congenital Abnormality
Cystic Fibrosis Transmembrane Conductance Regulator
Diagnosis
Drainage
Endoscopic Retrograde Cholangiopancreatography
Ethics Committees, Research
Hereditary pancreatitis
Hospitalization
Hyperamylasemia
Lipase
Mutation
Narcotics
Pain
Pancreas
Pancreatic Duct
Pancreatic Function Test
Pancreatitis, Acute
Parent
Patients
Physiologic Calcification
PRSS1 protein, human
Secretin
Serum
Surgical Endoscopy
X-Ray Computed Tomography
Abdomen
Cholangiopancreatography, Magnetic Resonance
Disease Progression
Endoscopic Retrograde Cholangiopancreatography
Ethics Committees, Research
Genetic Predisposition to Disease
Hereditary pancreatitis
Pancreatic Diseases
Pancreatitis
Patients
Physiologic Calcification
Radionuclide Imaging
Replicon
X-Ray Computed Tomography
Abdominal Pain
BLOOD
Chronic Pain
Diagnosis
Disabled Persons
Eligibility Determination
Endoscopic Retrograde Cholangiopancreatography
Ethics Committees, Research
North American People
Pain
Pancreatitis
Pancreatitis, Chronic
Patients
Abdomen
Clinical Reasoning
Congenital Abnormality
Cyst
Cytological Techniques
Diagnosis
Endoscopic Retrograde Cholangiopancreatography
Gastroenterologist
Hereditary pancreatitis
Malignant Neoplasms
Neoplasms, Mucinous
Operative Surgical Procedures
Pancreas
Pancreatic Neoplasm
Pathologists
Patients
Physicians
Surgeons
Vision
Between May 2000 and November 2006, 213 patients underwent a partial hepatectomy. Of all patients undergoing major liver resection (three or more Couinaud segments), both CT volumetry and HBS were preoperatively performed in 71 patients. Sixteen patients were excluded from the study because of preoperative PVE (n = 15) or partial portal vein thrombosis (n = 1) in the time period between HBS and CT volumetry. Hence, a group of 55 patients was retrospectively analyzed with the approval of our Institutional Review Board with waiver of informed consent. Table 1 summarizes the types of resection performed. Patients with a preoperative suspicion of hilar cholangiocarcinoma underwent an (extended) hemihepatectomy combined with hilar resection and caudate lobe resection. In cholestatic patients, preoperative biliary drainage was performed more than 6 weeks prior to surgery using endoscopic retrograde cholangiopancreatography or percutaneous transhepatic drainage.
5 ). Histopathology of the resection specimen was assessed by an experienced pathologist taking into account features of cholestasis, steatosis, fibrosis, and chronic inflammation.
Postoperative complications were recorded according to the modified classification of surgical complications proposed by Dindo et al.18 (link) In-hospital complications were recorded as well as complications requiring hospital readmission within 3 months related to the operation. Minor complications included grade 1 and grade 2 complications. Major complications were defined as grade 3 and severe complications as grade 4 and grade 5 complications. Liver failure was defined as bilirubin plasma levels >50 µmol/l and/or prothrombin time index <50%,19 (link) elevated plasma ammonia levels combined with signs of hepatic encephalopathy and/or hepatorenal syndrome, requiring intensive care treatment.
Types of Liver Resection with the Corresponding Weight of the Resection Specimen
| procedure | Number of patients | Percentage | Weight resection specimen (g) |
|---|---|---|---|
| Extended right hemihepatectomy | 14 | 25.5 | 975 ± 247 |
| Right hemihepatectomy | 26 | 47.2 | 936 ± 396 |
| Extended left hemihepatectomy | 1 | 1.8 | 443 |
| Left hemihepatectomy | 14 | 25.5 | 348 ± 120 |
| Total | 55 | 100.0 |
Postoperative complications were recorded according to the modified classification of surgical complications proposed by Dindo et al.18 (link) In-hospital complications were recorded as well as complications requiring hospital readmission within 3 months related to the operation. Minor complications included grade 1 and grade 2 complications. Major complications were defined as grade 3 and severe complications as grade 4 and grade 5 complications. Liver failure was defined as bilirubin plasma levels >50 µmol/l and/or prothrombin time index <50%,19 (link) elevated plasma ammonia levels combined with signs of hepatic encephalopathy and/or hepatorenal syndrome, requiring intensive care treatment.
Ammonia
Bile
Bilirubin
Cholestasis
Drainage
Endoscopic Retrograde Cholangiopancreatography
Ethics Committees, Research
Fibrosis
Hepatectomy
Hepatic Encephalopathy
Hepatic Insufficiency
Hepatorenal Syndrome
Hospital Readmissions
Inflammation
Intensive Care
Klatskin Tumor
Pathologists
Patients
Plasma
Postoperative Complications
Steatohepatitis
Times, Prothrombin
Venous Thrombosis
Most recents protocols related to «Endoscopic Retrograde Cholangiopancreatography»
The study design was retrospective cohort study. The study proposal was approved by The Human Research Ethics Committee of Thammasat University (Medicine). The patients, who presented with symptomatic GS or complications of GS, then underwent LC since January 2017 to December 2021 in service of Hepato-Pancreato-Biliary and Transplantation unit in surgery department of Thammasat University Hospital, were considered to be enrolled into this study. The electronic medical record was thoroughly reviewed.
The important information including demographic data, clinical presentation, laboratory results, and radiological findings was collected. The operative time, intraoperative findings, perioperative complications, and conversion to open surgery were reviewed from operative notes. The laparoscopic procedure was carried out through three or four small incisions at umbilical and right upper quadrant areas. The operative time was counted from the opening of the first port-site incision to the closure of the last surgical wounds.
Some cases might be excluded because of the following reasons: (1) patients who underwent LC with other indication such as gallbladder polyp, (2) LC was performed in emergency setting for treatment of acute cholecystitis, and (3) there were any other procedures performed in the same setting of LC such as intraoperative ERCP. By the perioperative information, the patients were categorized into three groups by difficulty grading as given inTable 2 .
The univariate analysis was performed using chi-square test for categorical data and Student's t-test for continuous data to define the significant factors affecting on very difficult LC and converted cases. Then multivariate analysis was carried out for both outcomes. Thereafter, the preoperative predictive scores of each patient were calculated using the original Randhawa scoring systems and also the modification of Tongyoo et al. The comparison between scores from both models was performed by many methods such as paired t-test, correlation coefficient, and area under receiver operating characteristic (ROC) curve. All of statistical analyses were performed by IBM SPSS® Statistics version 20 and their results were determined to be significant at P < .05.
The important information including demographic data, clinical presentation, laboratory results, and radiological findings was collected. The operative time, intraoperative findings, perioperative complications, and conversion to open surgery were reviewed from operative notes. The laparoscopic procedure was carried out through three or four small incisions at umbilical and right upper quadrant areas. The operative time was counted from the opening of the first port-site incision to the closure of the last surgical wounds.
Some cases might be excluded because of the following reasons: (1) patients who underwent LC with other indication such as gallbladder polyp, (2) LC was performed in emergency setting for treatment of acute cholecystitis, and (3) there were any other procedures performed in the same setting of LC such as intraoperative ERCP. By the perioperative information, the patients were categorized into three groups by difficulty grading as given in
The univariate analysis was performed using chi-square test for categorical data and Student's t-test for continuous data to define the significant factors affecting on very difficult LC and converted cases. Then multivariate analysis was carried out for both outcomes. Thereafter, the preoperative predictive scores of each patient were calculated using the original Randhawa scoring systems and also the modification of Tongyoo et al. The comparison between scores from both models was performed by many methods such as paired t-test, correlation coefficient, and area under receiver operating characteristic (ROC) curve. All of statistical analyses were performed by IBM SPSS® Statistics version 20 and their results were determined to be significant at P < .05.
Acute Cholecystitis
Conversion to Open Surgery
Emergencies
Endoscopic Retrograde Cholangiopancreatography
Ethics Committees, Research
Gallbladder
Homo sapiens
Laparoscopy
Operative Surgical Procedures
Patients
Pharmaceutical Preparations
Polyps
Surgical Wound
Transplantation
Umbilicus
X-Rays, Diagnostic
All procedures were performed using CO
2insufflation with the patient in prone or left lateral decubitus position under conscious sedation controlled by an anesthesiologist and a nurse. The study procedures were performed using a floor-mounted Siemens Artis zee multi-purpose (MP) fluoroscopy system (Siemens Healthcare, Erlangen, Germany) or a mobile Siemens Cios Alpha c-arm device (Siemens Healthcare, Erlangen, Germany). Fixed, mobile, and ceiling-mounted radiation shields and personal protective equipment, such as protective aprons, thyroid shields, and leaded eyewear were used during all the procedures. A more detailed description of the imaging protocols and radiation protection tools implemented is provided as supplementary material.
Other data collected for each procedure included patient characteristics (age, height, weight, and body mass index [BMI]), fluoroscopy time, KAP, and air-kerma at reference point (K
a,r). Moreover, the procedural complexity of each ERCP was determined and collected based on the 4-point American Society for Gastrointestinal Endoscopy (ASGE) complexity-grading system
18 (link)
19
. The radiation doses in ERCP and other gastrointestinal endoscopy procedures were compared. ERCPs performed for diagnosis and follow up of PSC included a significantly larger number of single image exposures compared to other ERCPs and were thus categorized separately. The effect of ERCP procedural complexity level and fluoroscopy system on radiation doses was then analyzed.
Anesthesiologist
Conscious Sedation
Cranioosteoarthropathy
Diagnosis
Endoscopic Retrograde Cholangiopancreatography
Endoscopy, Gastrointestinal
Fluoroscopy
Index, Body Mass
Nurses
Patients
Radiation Protection
Radiotherapy
Surgical Procedures, Endoscopic Gastrointestinal
Thyroid Gland
The data are presented as median (interquartile range [IQR], i. e., first quartile – third quartile). To compare categorical and continuous variables between patient characteristics, procedure types, fluoroscopy systems, ERCP procedural complexity levels, and interventionists, either Fisher’s Exact test or Mann-Whitney
U-test and Kruskal-Wallis test were used, respectively. All statistical tests were two-sided, and a
P < 0.05 was considered significant. Statistical analysis was performed with SPSS statistical software (IBM, Armonk, New York, United States, version 25.0).
Endoscopic Retrograde Cholangiopancreatography
Fluoroscopy
Patients
This prospective observational study to determine occupational radiation doses was performed at the Helsinki University Hospital Endoscopy department between March 2021 and July 2021. The COVID-19 pandemic did not affect the number or type of performed procedures. Altogether 604 consecutive fluoroscopy-guided procedures to patients were included in the study. From these interventions, 560 were ERCPs and 44 were other gastrointestinal endoscopy procedures, such as duodenal stentings or dilatations of anastomotic strictures. Personal dose equivalents H
p(10), H
p(0.07), and H
p(3) for four gastrointestinal surgeons (S1-S4) and four gastroenterologists (G1-G4) and for assisting nurses (N_Zee and N_Cios) were measured using thermoluminescent dosimeters (TLD) and direct-ion storage dosimeters (DIS). Details of dosimetry practices and dose uncertainty estimation are provided as supplementary material. In the endoscopy department, ERCPs for diagnosis and follow up of primary sclerosing cholangitis (PSC) and dilatations and stentings for these patients are performed by gastroenterologists; surgeons perform all other ERCP procedures. Distributions of the performed and assisted procedures by endoscopist and assisting nurse are given in Table 1 s (supplementary materials). The study was approved by the Institutional Review Board and no patient informed consent was required.
COVID 19
Cranioosteoarthropathy
Diagnosis
Dilatation
Duodenum
Endoscopic Retrograde Cholangiopancreatography
Endoscopy, Gastrointestinal
Ethics Committees, Research
Fluoroscopy
Gastroenterologist
Nurses
Patients
Primary Sclerosing Cholangitis
Radiometry
Radiotherapy
Stenosis
Stents
Surgeons
Surgical Anastomoses
Surgical Procedures, Endoscopic Gastrointestinal
PSC is progressive biliary fibrosis affecting intra and/or extrahepatic bile ducts[12 (link)] and diagnosed by laboratory tests [(cholestasis, Antineutrophil cytoplasmic antibodies (ANCA)], radiology [abdominal ultrasonography (US), abdominal computed tomography (CT), endoscopic retrograde cholangiopancreatography (ERCP), or magnetic resonance cholangiopancreatography (MRCP)], and liver biopsy. Primary biliary cholangitis (PBC) is characterized by the loss of small and medium-sized bile ducts on liver biopsy, elevated anti-mitochondrial antibodies, and altered gamma-glutamyl transferase and alkaline phosphatase (ALP) levels[13 (link)]. Non-alcoholic fatty liver disease (NAFLD) is characterized by fat storage in ≥ 5% of hepatic steatosis in the absence of concomitant liver disease (chronic viral hepatitis), use of steatosis-inducing medications (amiodarone or tamoxifen), autoimmune hepatitis, hemochromatosis, Wilson's disease, or excessive alcohol consumption[14 (link)]. Diagnosis of NAFLD was made by liver biopsies or US[15 (link)], and the severity score was previously stated[16 (link)]. Autoimmune hepatitis diagnosis based on the International Autoimmune Hepatitis Group criteria with a score of > 15 points consisting of demographic, histologic, and laboratory markers, including antinuclear antibodies with a titer of at least 1:40 and liver histology[17 (link)]. An aseptic liver abscess is diagnosed based on IBD history, US, and CT[18 (link)]. Ultrasound, colour Doppler, and/or CT scans were used to detect portal vein thrombosis.
Abdomen
Alkaline Phosphatase
Amiodarone
Anti-Antibodies
Antibodies, Antinuclear
Antineutrophil Cytoplasmic Antibodies
Asepsis
Autoimmune Chronic Hepatitis
Bile
Bile Ducts, Extrahepatic
Biopsy
Cholangiopancreatography, Magnetic Resonance
Cholestasis
Duct, Bile
Endoscopic Retrograde Cholangiopancreatography
Fatty Liver
Fibrosis
gamma-Glutamyl Transpeptidase
Hemochromatosis
Hepatic Duct
Hepatitis, Chronic
Hepatolenticular Degeneration
Liver
Liver Abscess
Liver Diseases
Mitochondria
Non-alcoholic Fatty Liver Disease
Pharmaceutical Preparations
Primary Biliary Cholangitis
Radiography
Radionuclide Imaging
Steatohepatitis
Tamoxifen
Thrombosis
Ultrasonography
Veins, Portal
Venous Thrombosis
X-Ray Computed Tomography
Top products related to «Endoscopic Retrograde Cholangiopancreatography»
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The TJF-260V is a video duodenoscope designed for diagnostic and therapeutic procedures in the upper gastrointestinal tract. It features a slim, flexible insertion tube and a wide, forward-viewing field of view.
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The JF-260V is a laboratory equipment product manufactured by Olympus. It is a high-quality instrument designed for precise and reliable measurements in various scientific and research applications. The core function of the JF-260V is to provide accurate and reproducible results for the user's specific needs. Further details on the intended use or specific features of the product are not available within the scope of this request.
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The TJF-240 is a medical imaging device designed for endoscopic procedures. It features a flexible insertion tube, a high-resolution video system, and a range of accessories to support various medical applications. The device's core function is to provide healthcare professionals with a tool for capturing and displaying high-quality images and videos during diagnostic and therapeutic procedures.
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The TJF-260 is a versatile video duodenoscope designed for endoscopic retrograde cholangiopancreatography (ERCP) procedures. It features a slim, flexible insertion tube and a distal end with a wide field of view to enable improved visualization of the papilla of Vater and the bile and pancreatic ducts.
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The VisiGlide2 is a lab equipment product from Olympus. It is a microscope slide intended for use in various scientific applications. The VisiGlide2 provides a clear and stable surface for samples under observation.
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Jagwire is a lab equipment product designed for use in various research and diagnostic applications. It serves as a versatile cable system capable of transmitting data, signals, or power between connected devices. The core function of Jagwire is to facilitate reliable and efficient connectivity within the lab environment.
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The JF-240 is a laboratory microscope designed for a variety of applications. It features high-quality optics, providing clear and detailed imaging. The microscope is equipped with various magnification levels to accommodate different sample types and observation needs.
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Wallflex is a laboratory equipment product manufactured by Boston Scientific. It is designed to serve as a component in laboratory settings, providing a specialized function. The core function of Wallflex is to facilitate specific laboratory processes, though a detailed description cannot be provided while maintaining an unbiased and factual approach.
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The VisiGlide is a lab equipment product designed to provide a clear and detailed view of microscopic samples. It features a high-quality optical system that delivers exceptional image quality and resolution. The VisiGlide is a versatile tool suitable for a wide range of laboratory applications.
More about "Endoscopic Retrograde Cholangiopancreatography"
Endoscopic Retrograde Cholangiopancreatography (ERCP) is a minimally invasive diagnostic and therapeutic procedure used to examine and treat conditions affecting the bile and pancreatic ducts.
This complex procedure involves the insertion of a flexible endoscope, such as the TJF-260V, JF-260V, TJF-240, or TJF-260, through the mouth, down the esophagus, and into the small intestine, allowing access to the targeted ducts.
ERCP enables the visualization, diagnosis, and treatment of various disorders, including gallstones, bile duct strictures, and pancreatic diseases.
It is a crucial tool in the management of these conditions, often used in conjunction with other specialized devices like the VisiGlide2, JF-260, Jagwire, JF-240, or Wallflex.
Performing ERCP requires specialized training and expertise to ensure safe and effective execution, as the procedure carries the potential for serious complications.
Optimizing ERCP protocols and techniques, such as those found in the literature, pre-prints, and patents, is essential for enhancing medical research and improving patient outcomes.
PubCompare.ai is a powerful AI-driven platform that helps researchers and clinicians identify the most effective ERCP protocols and techniques, leveraging the latest advancements in artificial intelligence to inform and improve their medical practices.
By utilizing PubCompare.ai, you can discover the best ERCP approaches, enhance your research, and ultimately provide better care for your patients.
This complex procedure involves the insertion of a flexible endoscope, such as the TJF-260V, JF-260V, TJF-240, or TJF-260, through the mouth, down the esophagus, and into the small intestine, allowing access to the targeted ducts.
ERCP enables the visualization, diagnosis, and treatment of various disorders, including gallstones, bile duct strictures, and pancreatic diseases.
It is a crucial tool in the management of these conditions, often used in conjunction with other specialized devices like the VisiGlide2, JF-260, Jagwire, JF-240, or Wallflex.
Performing ERCP requires specialized training and expertise to ensure safe and effective execution, as the procedure carries the potential for serious complications.
Optimizing ERCP protocols and techniques, such as those found in the literature, pre-prints, and patents, is essential for enhancing medical research and improving patient outcomes.
PubCompare.ai is a powerful AI-driven platform that helps researchers and clinicians identify the most effective ERCP protocols and techniques, leveraging the latest advancements in artificial intelligence to inform and improve their medical practices.
By utilizing PubCompare.ai, you can discover the best ERCP approaches, enhance your research, and ultimately provide better care for your patients.