PMID- 29912853
OWN - NLM
STAT- MEDLINE
DCOM- 20190110
LR  - 20190110
IS  - 1536-4828 (Electronic)
IS  - 0885-3177 (Linking)
VI  - 47
IP  - 7
DP  - 2018 Aug
TI  - Adverse Events and Reinterventions Following Pancreatic Endoscopic 
      Sphincterotomy.
PG  - 880-883
LID - 10.1097/MPA.0000000000001084 [doi]
AB  - OBJECTIVES: Pancreatic endoscopic sphincterotomy (PES) is an independent risk 
      factor for short- and long-term adverse events (AEs) of endoscopic retrograde 
      cholangiopancreatography. We sought to measure PES-specific AEs and trends in the 
      use of PES. METHODS: This was a retrospective cohort of consecutive patients who 
      underwent first-time PES between June 2008 and June 2015. Indications for PES 
      were dichotomized: (1) structural pathology (chronic pancreatitis and local 
      complications of acute pancreatitis) and (2) suspected sphincter pathology 
      (idiopathic recurrent acute pancreatitis and sphincter of Oddi dysfunction). 
      Rates of AEs and pancreatic orifice reinterventions were measured, with 
      reintervention rates limited to those having a minimum of 12-month follow-up. 
      RESULTS: Of 567 patients, 198 (34.9%) underwent PES for structural and 369 
      (65.1%) for suspected sphincter pathology. Rates of post-endoscopic retrograde 
      cholangiopancreatography pancreatitis and unplanned hospitalization were high 
      when PES was originally performed for suspected sphincter pathology (12.6% and 
      14.6%, respectively). The overall reintervention rate was 28.9% and significantly 
      greater for sphincter (41.7%) compared with structural pathology (13.5%, P = 
      0.005). CONCLUSIONS: The likelihood of reintervention after PES is high, 
      particularly when the primary indication is suspected sphincter pathology such as 
      idiopathic recurrent acute pancreatitis. Further prospective studies are needed 
      to clarify if and when this maneuver confers significant benefit to patients.
FAU - Dufault, Darin L
AU  - Dufault DL
FAU - Elmunzer, B Joseph
AU  - Elmunzer BJ
FAU - Cotton, Peter B
AU  - Cotton PB
FAU - Williams, April
AU  - Williams A
FAU - Cote, Gregory A
AU  - Cote GA
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Pancreas
JT  - Pancreas
JID - 8608542
SB  - IM
MH  - Acute Disease
MH  - Cholangiopancreatography, Endoscopic Retrograde/*methods
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Pancreas/pathology/physiopathology/*surgery
MH  - Pancreatic Ducts/pathology/physiopathology/surgery
MH  - Pancreatitis/etiology/pathology/physiopathology
MH  - Recurrence
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Sphincter of Oddi/pathology/physiopathology/*surgery
MH  - Sphincterotomy, Endoscopic/adverse effects/*methods
EDAT- 2018/06/19 06:00
MHDA- 2019/01/11 06:00
CRDT- 2018/06/19 06:00
PHST- 2018/06/19 06:00 [pubmed]
PHST- 2019/01/11 06:00 [medline]
PHST- 2018/06/19 06:00 [entrez]
AID - 10.1097/MPA.0000000000001084 [doi]
PST - ppublish
SO  - Pancreas. 2018 Aug;47(7):880-883. doi: 10.1097/MPA.0000000000001084.