The Role of Endoscopic Retrograde Cholangiopancreatography (ERCP) in the Management of Intra-Biliary Rupture of Liver Hydatid Cysts (IBRH): Follow-Up of 12 Cases

AbstractAcute pancreatitis is the most common iatrogenic dilemma of endoscopic retrograde cholangiopancreatography, and it is associated with significant morbidity and mortality. Several factors have been implicated in the pathogenesis of post-endoscopic retrograde cholangiopancreatography pancreatitis, and preventive measures were practiced accordingly. This study aims to refine the potential mechanisms that trigger post-endoscopic retrograde cholangiopancreatography pancreatitis and define the role of enteropeptidase in the pathogenesis of post-endoscopic retrograde cholangiopancreatography pancreatitis. Furthermore, address the role of a new novel medication known as SCO-792, a potent enteropeptidase inhibitor, in the prevention of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis.Post-endoscopic retrograde cholangiopancreatography pancreatitis is caused by premature activation of the pancreatic enzymes within the pancreatic parenchyma. This activation is either an autoactivation due to direct provocation of intra-acinar enzymes as a result of the procedure or due to activation by enterpeptidase, a rate-limiting enzyme. Endoscopic retrograde cholangiopancreatography interjects duodenal juice that is rich in enterokinase into the pancreatic-biliary tract, which in turn leads to intra-ductal activation of trypsinogen and subsequent enzymes. Given the vital role of enterokinase in initiating the pathogenesis of pancreatitis, enteropeptidase inhibition may prevent and reduce the severity of post-endoscopic retrograde cholangiopancreatography pancreatitis.SCO-792, a novel enteropeptidase inhibitor, is developed by SCOHIA Pharma, and pre-clinical trials confirmed its efficacy in inhibiting enteropeptidase. Studies are needed to confirm the efficacy of enteropeptidase inhibitors in preventing post-endoscopic retrograde cholangiopancreatography pancreatitis.

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Cystic and alveolar echinococcosis of the hepatobiliary tract – the role of new imaging techniques for improved diagnosis

Medical Ultrasonography ◽

10.11152/mu-2421 ◽

2020 ◽

Vol 1 (1) ◽

pp. 75 ◽

Cited By ~ 1

Author(s):

Christoph F Dietrich ◽

Wiem Douira-Khomsi ◽

Hassen Gharbi ◽

Malay Sharma ◽

Xin Wu Cui ◽

...

Keyword(s):

Alveolar Echinococcosis ◽

Wide Spectrum ◽

Imaging Techniques ◽

Imaging Features ◽

Hydatid Cysts ◽

Fatal Disease ◽

Symptomatic Infection ◽

Hepatobiliary Tract

Cystic echinococcosis (CE) or hydatidosis (hydatid cysts) is an infection with a wide spectrum of manifestations, from symptomatic infection to fatal disease. Ultrasound (US) allows screening, diagnosis, differential diagnosis, treatment guidance and follow-up of CE under many circumstances. Hydatid cysts are predominantly observed in the liver. Herewith we present a review to demonstrate established and innovative imaging features of CE of the hepatobiliary tract.

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Hepatic Hydatid cyst Cystobiliary Communication, Case Report & Literature Review

10.47363/jghr/2020(1)103 ◽

2020 ◽

Vol 1 (1) ◽

pp. 1-3

Author(s):

Hallal Mahmoud ◽

◽

Mroue Ahmad ◽

Kayal Mira ◽

◽

...

Keyword(s):

Case Report ◽

Literature Review ◽

Obstructive Jaundice ◽

Hydatid Cyst ◽

Endoscopic Retrograde Cholangiopancreatography ◽

Hydatid Cysts ◽

Hepatic Hydatid Cyst ◽

Endoscopic Retrograde ◽

Surgical Treatments ◽

Hepatic Hydatid

Hepatic hydatid cysts are benign cysts in the liver that are the result of parasites infection. They are caused by echinoccocus granulosis or multilocularis. They caused several symptoms like pain, obstructive jaundice, and sepsis. Hydatid cyst can be complicated to cystobiliary communication (CBC) which can be frank CBC or occult CBC. Medical, endoscopic, percutaneous and surgical treatments are different approaches to treat hydatid cyst. Here we report a case of hepatic hydatid cyst with cystobiliary communication, causing obstructive jaundice and treated with sphincterotomy and insertion of biliary stent through endoscopic retrograde cholangiopancreatography (ERCP).

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Spectrum of periampullary lesions and the role of endoscopic retrograde cholangiopancreatography in their diagnosis

Journal of Current Medical Research and Practice ◽

10.4103/jcmrp.jcmrp_163_19 ◽

2021 ◽

Vol 6 (1) ◽

pp. 25

Author(s):

EmadM Abd-Elkhalik ◽

MorsyM Morsy ◽

SalahI Mohammed ◽

MahmoudR Shehata ◽

AdnanA Mohammed

Keyword(s):

Endoscopic Retrograde Cholangiopancreatography ◽

Endoscopic Retrograde

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Endoscopic Retrograde Cholangiopancreatography in General Surgery: How Much are We Outsourcing?

The American Surgeon ◽

10.1177/000313480907501104 ◽

2009 ◽

Vol 75 (11) ◽

pp. 1050-1053

Author(s):

Wesley B. Jones ◽

Richard H. Roettger ◽

William S. Cobb ◽

Alfredo M. Carbonell

Keyword(s):

Endoscopic Retrograde Cholangiopancreatography ◽

Tertiary Care ◽

Patient Characteristics ◽

Surgical Patients ◽

Time Interval ◽

Endoscopic Retrograde ◽

Care Surgery ◽

Surgery Department ◽

Nonsurgical Patients

Although surgeons can safely perform endoscopic retrograde cholangiopancreatography (ERCP), it has fallen within the domain of gastroenterologists. We sought to quantify the role of ERCP in a tertiary-care surgery department. The hospital discharge database was queried for all ERCPs performed from January 2007 to December 2007. Gastroenterologists performed all ERCPs in our query. Surgical patients were admitted and/or under the care of a surgeon; whereas nonsurgical patients had no surgeon involvement. Patient characteristics and diagnoses were compared between groups. ERCP procedural details were recorded. Surgical patients comprised 48 per cent (n = 151) of the total 311 ERCPs performed. The mean time interval from a surgeon's request for ERCP to actual procedure was 2.43 days (standard deviation [SD] 2.55; range, 0-13 days). The surgical group had significantly different diagnoses and underwent less diagnostic (22% vs 56%) and more therapeutic ERCPs (72% vs 38%). Surgical patients were more likely inpatients (82.1% vs 16.8%) with a longer length of stay (6.7 vs 3.9 days; P = 0.0029) compared with nonsurgical patients. We found surgical patients requiring ERCP differ significantly from nonsurgical patients, with a significant number of technical interventions being outsourced. Given the benefits of a surgical ERCP program and the potential volume of these unique patients, this procedure should be performed by appropriately trained surgeons.

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