Methods of acute pancreatitis prevention after endoscopic transpapillary interventions

Beburishvili A.G.; Zyubina E.N.; Turovets M.I.; Mandrikov V.V.

doi:https://doi.org/10.17116/hirurgia2015835-40

Beburishvili A.G.

Kafedra fakul'tetskoĭ khirurgii Volgogradskogo gosudarstvennogo meditsinskogo universiteta

Zyubina E.N.

Volgograd State Medical University, Department of Faculty Surgery with the course of endoscopic surgery and with the course of Cardiovascular Surgery, Faculty of Continuing Medical Education, Center for Surgical Hepatology

Turovets M.I.

Volgograd State Medical University, Volgograd scientific medical center, Volgograd, Russia

Mandrikov V.V.

Volgograd State Medical University, Volgograd scientific medical center, Volgograd, Russia

Methods of acute pancreatitis prevention after endoscopic transpapillary interventions

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Beburishvili A.G., Zyubina E.N., Turovets M.I., Mandrikov V.V.

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Journal: Pirogov Russian Journal of Surgery. 2015;(8): 35‑40

DOI: 10.17116/hirurgia2015835-40

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To cite this article:

Beburishvili AG, Zyubina EN, Turovets MI, Mandrikov VV. Methods of acute pancreatitis prevention after endoscopic transpapillary interventions. Pirogov Russian Journal of Surgery. 2015;(8):35‑40. (In Russ.)
https://doi.org/10.17116/hirurgia2015835-40

Подписка 2026 Хирургия. Журнал им. Н.И. Пирогова (Pirogov Russian Journal of Surgery)

Использование инфографики авторами научных работ

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Abstract:

Aim. To optimize preventive methods of acute postoperative pancreatitis in endoscopic transpapillary interventions. Material and methods. It is performed parallel unblinded randomized investigation. The first group included 98 patients who underwent endoscopic transpapillary interventions and thoracic epidural analgesia (TEA). The second group consisted of 97 patients in whom opiate analgesic intramuscularly and indomethacin per rectum were applied. Results. Study revealed that acute pancreatitis has been diagnosed significantly more seldom in patients after TEA than in the second group (OR 0.22, CI 95%, 0.06-0.83). Thus in TEA-group pancreatitis was verified in 3.1% (3 of 98 patients), in the second group - in 12.4% (12 of 97 patients). Incidence of pancreatitis decreased from 23.3% (10 of 43) to 4.3% (2 of 46) among high risk patients (OR 0.15, 95% CI 0.03-0.75). Conclusion. TEA is effective and justified preventive method in patients with high risk of postoperative pancreatitis. In low risk patients use of indomethacin per rectum is preferred compared with TEA due to its invasiveness.

Keywords:

endoscopic transpapillary intervention

thoracic epidural analgesia

prevention of acute postoperative pancreatitis

Authors:

Beburishvili A.G.

Kafedra fakul'tetskoĭ khirurgii Volgogradskogo gosudarstvennogo meditsinskogo universiteta

Zyubina E.N.

Turovets M.I.

Volgograd State Medical University, Volgograd scientific medical center, Volgograd, Russia

Mandrikov V.V.

Volgograd State Medical University, Volgograd scientific medical center, Volgograd, Russia

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References:

Beburishvili А.G., Zyubina E.N., Turovets M.I. i dr. EHpidural'naya analgeziya kak metod profilaktiki razvitiya ostrogo posleoperatsionnogo pankreatita pri ehndoskopicheskikh transpapillyarnykh vmeshatel'stvakh [Epidural analgesia as a method of acute postoperative pancreatitis prevention in endoscopic transpapillary interventions]. Vestnik VolgGMU; 2011;2(38):63-66. (in Russian)
Turovets M.I., Zyubina E.N., Spiridonov E.G., Аkinchits А.N. Sposob opredeleniya individual'nogo riska razvitiya ostrogo pankreatita posle ehndoskopicheskikh transpapillyarnykh vmeshatel'stv [Determination of individual risk of acute pancreatitis after endoscopic transpapillary interventions]. Patent na izobretenie №2506037;10.02.2014. (in Russian)
Abdel Aziz AM, Lehman GA. Pancreatits after endoscopic retrograde cholangiopancreatography. Gastroenterol. 2007;13:2655-2668.
Andriulli A, Clemente R, Solmi L et al. Gabexate or somatostatin administration before ERCP in patients at high risk for post-ERCP pancreatitis: a multicenter, placebo-controlled, randomized clinical trial. Gastrointest Endosc. 2002;56:488-495.
Andriulli A, Loperfido S, Napolitano G et al. Incidence rates of post-ERCP complications: a systematic survey of prospective studies. Am J Gastroenterol. 2007;102:1781-1788.
Bang UC, Nojgaard C, Andersen PK, Matzen P. Meta-analysis: Nitroglycerin for prevention of post-ERCP pancreatitis. Aliment Pharmacol Ther. 2009;29:1078-1085.
Barkay O, Niv E, Santo E et al. Low-dose heparin for the prevention of post-ERCP pancreatitis: a randomized placebo-controlled trial. Surg Endosc. 2008;22:1971-1976.
Bilbao MK, Dotter CT, Lee TG et al. Complications of endoscopic retrograde cholangiopancreatography (ERCP). A study of 10,000 cases. Gastroenterology. 1976;70:314-320.
Cennamo V, Fuccio L, Zagari RM et al. Can a wire-guided cannulation technique increase bile duct cannulation rate and prevent post-ERCP pancreatitis? A meta-analysis of randomized controlled trials. Am J Gastroenterol. 2009;104:2343-2350.
Cheung J, Tsoi KK, Quan W-L, Lau JYW, Sung JJY. Guidewire versus conventional contrast cannulation of the common bile duct for the prevention of post-ERCP pancreatitis: a systematic review and meta-analysis. Gastrointest Endosc. 2009;70:1211-1219.
Christensen M, Matzen P, Schulze S et al. Complications of ERCP: a prospective study. Gastrointest Endosc. 2004;60:721-731.
Cotton PB, Garrow DA, Gallagher J et al. Risk factors for complications after ERCP: a multivariate analysis of 11,497 procedures over 12 years. Gastrointest Endosc. 2009;70:80-88.
Dumonceau J-M, Andriulli A, Deviere J et al. Guideline: Prophylaxis of post-ERCP pancreatitis. Endoscopy. 2010;42:503-515.
Freeman ML, DiSario JA, Nelson DB et al. Risk factors for post-ERCP pancreatitis: a prospective, multicenter study. Gastrointest Endosc. 2001;54:425-434.
Friedland S, Soetikno RM, Vandervoort J et al. Bedside scoring system to predict the risk of developing pancreatitis following ERCP. Endoscopy. 2002;34:483-488.
Garcia-Cano LJ, Gonzalez-Martin JA, Morillas-Arino J et al. Complications of endoscopic retrograde cholangiopancreatography. A study in a small ERCP unit. Rev Esp Enferm Dig. 2004;96:163-173.
Herreros de Tejada A, Calleja JL, Díaz G et al. Double-guidewire technique for difficult bile duct cannulation: a multicenter randomized, controlled trial. Gastrointest Endosc. 2009;70:700-709.
Lavy A, Karban A, Suissa A et al. Natural beta-carotene for the prevention of post-ERCP pancreatitis. Pancreas. 2004;29:45-50.
Lee KT, Lee DH, Yoo BM. The prophylactic effect of somatostatin on post-therapeutic endoscopic retrograde cholangiopancreatography pancreatitis. Pancreas. 2008;37:445-448.
Loperfido S, Angelini G, Benedetti G et al. Major early complications from diagnostic and therapeutic ERCP: a prospective multicenter study. Gastrointest Endosc. 1998;48:1-10.
Maeda S, Hayashi H, Hosokawa O et al. Prospective randomized pilot trial of selective biliary cannulation using pancreatic guide-wire placement. Endoscopy. 2003;35:721-724.
Mallery JS, Baron TH, Dominitz JA et al. Complications of ERCP. Gastrointest Endosc. 2003;57:633-638.
Maple JT, Keswani RN, Hovis RM et al. Carbon dioxide insufflation during ERCP for reduction of postprocedure pain: a randomized, doubleblind, controlled trial. Gastrointest Endosc. 2009;70:278-283.
Masci E, Mariani A, Curioni S, Testoni PA. Risk factors for pancreatitis following endoscopic retrograde cholangiopancreatography: a metaanalysis. Endoscopy. 2003;35:830-834.
Masci E, Toti G, Mariani A et al. Complications of diagnostic and therapeutic ERCP: a prospective multicenter study. Am J Gastroenterol. 2001;96:417-423.
Rabenstein T, Schneider HT, Bulling D et al. Analysis of the risk factors associated with endoscopic sphincterotomy techniques: preliminary results of a prospective study, with emphasis on the reduced risk of acute pancreatitis with low-dose anticoagulation treatment. Endoscopy. 2000;32:10-19.
Shao LM, Chen QY, Chen MY, Cai JT. Nitroglycerin in the prevention of post-ERCP pancreatitis: a meta-analysis. Dig Dis Sci. 2010;55:1-7.
Vandervoort J, Soetikno RM, Tham TCK et al. Risk factors for complications after performance of ERCP. Gastrointest Endosc. 2002;56:652-656.
Verma D, Kapadia A, Adler DG. Pure versus mixed electrosurgical current for endoscopic biliary sphincterotomy: a meta-analysis of adverse outcomes. Gastrointest Endosc. 2007;66:283-290.
Wagh MS, Sherman S. Indomethacin for post-ERCP pancreatitis prophylaxis: another attempt at the Holy Grail. Am J Gastroenterol. 2007;102:984-986.