Background:Although the incidence of acute pancreatitis (AP) in children is increasing, management recommendations rely on adult published guidelines. Pediatric-specific recommendations are needed.Methods:The North American Society for Pediatric Gastroenterology, Hepatology and Nutrition Pan

/pdf/management-of-acute-pancreatitis-in-the-pediatric-population-3egntcm1si.pdf

Management of Acute Pancreatitis in the Pediatric Population: A Clinical Report From the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition Pancreas Committee.

https://www.gastroenterologyandhepatology.net/files/2013/09/gh0813_szaryalkawas1.pdf

Complications of Endoscopic Retrograde Cholangiopancreatography: How to Avoid and Manage Them

https://www.cghjournal.org/article/S1542-3565(12)01311-0/pdf

Endoscopic Management of Complications After Gastrointestinal Weight Loss Surgery

Context Post-ERCP pancreatitis is the most common complication of endoscopic retrograde cholangiopancreatography (ERCP). A simple method of predicting patients who are at risk of developing post-ERCP pancreatitis is needed to allow those at low risk to be discharged on the same day of their procedure. The aim of this study was to confirm that 4-hour post-ERCP serum amylase level is predictive of post-ERCP pancreatitis. Patients A study of 886 ERCPs performed at a single centre was conducted. Main outcome measure Four-hour amylase level was recorded, along with patient demographics, procedural details, presence of pancreatogram, and morbidity and mortality. Results Pancreatitis occurred in 4.4% of ERCPs. Hyperamylasaemia was found to be predictive of post-ERCP pancreatitis, with other risk factors being a younger age and pancreatogram. Hyperamylasaemia was also predictive of post-ERCP pancreatitis in the subgroup of patients who had undergone pancreatogram. Conclusions The 4-hour amylase level is a useful measure in the prediction of post-ERCP pancreatitis. Patients who have undergone pancreatogram should be admitted if 4-hour amylase level is greater than 2.5 times the upper limit of reference. Patients who have not undergone pancreatogram should be admitted if 4-hour amylase level is greater than 5 times the upper limit of reference. Image:  Proposed algorithm for selecting patients for same-day discharge post-ERCP.

/pdf/using-the-4-hour-post-ercp-amylase-level-to-predict-post-5cz72jsxh1.pdf

Using the 4-hour Post-ERCP Amylase Level to Predict Post-ERCP Pancreatitis

The frequency of endoscopic complications is likely to rise owing to the increased number of indications for therapeutic procedures and also to the increased complexity of endoscopic techniques. Informed patient consent should be obtained as part of the procedure. Prevention of endoscopic adverse events is based on knowledge of the relevant risk factors and their mechanisms of occurrence. Thus, suitable training of future gastroenterologists and endoscopists is required for these complex procedures. When facing a complication, appropriate management is generally provided by an early diagnosis followed by prompt therapeutic care tailored to the situation. The most common complications of diagnostic and therapeutic upper gastrointestinal endoscopy, retrograde cholangiopancreatography, small bowel endoscopy and colonoscopy are reviewed here. Different modalities of medical, endoscopic or surgical management are also considered.

Endoscopic complications--avoidance and management.

Endoscopic post-bypass revisions

1136 In Vivo Endoscope-Based Confocal Laser Endomicroscopy (eCLE) Improves Detection of Unlocalized Barrett's Esophagus-Related Neoplasia Over High Resolution White Light Endoscopy: an International Multicenter Randomized Controlled Trial

Exemplary apparatus for coupling to a probe and providing information regarding at least one structure can be provided. For example, the apparatus can include an electronics arrangement which is configured to obtain the information and transmit the information wirelessly, and a structural connection configuration which is structured and configured to be attached to the probe. The electronics arrangement can include a detector arrangement which is configured to detect at least one return radiation from at least one portion of at least one sample based on the predetermined patterns, and provide the data for the portion(s) based on the return radiation(s). In addition, a computer arrangement can be provided which is configured to generate the information with includes image data for the portion(s) as a function of the data and prior knowledge of the predetermined patterns.

Imaging apparatus and method which utilizes multidirectional field of view endoscopy

Imaging apparatus which utilizes multidirectional field of view endoscopy

The aim of this article is to review the literature regarding post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis. We searched for and evaluated all articles describing the diagnosis, epidemiology, pathophysiology, morbidity, mortality and prevention of post-ERCP pancreatitis (PEP) in adult patients using the PubMed database. Search terms included endoscopic retrograde cholangiopancreatography, pancreatitis, ampulla of vater, endoscopic sphincterotomy, balloon dilatation, cholangiography, adverse events, standards and utilization. We limited our review of articles to those published between January 1, 1994 and August 15, 2009 regarding human adults and written in the English language. Publications from the reference sections were reviewed and included if they were salient and fell into the time period of interest. Between the dates queried, seventeen large (> 500 patients) prospective and four large retrospective trials were conducted. PEP occurred in 1%-15% in the prospective trials and in 1%-4% in the retrospective trials. PEP was also reduced with pancreatic duct stent placement and outcomes were improved with endoscopic sphincterotomy compared to balloon sphincter dilation in the setting of choledocholithiasis. Approximately 34 pharmacologic agents have been evaluated for the prevention of PEP over the last fifteen years in 63 trials. Although 22 of 63 trials published during our period of review suggested a reduction in PEP, no pharmacologic therapy has been widely accepted in clinical use in decreasing the development of PEP. In conclusion, PEP is a well-recognized complication of ERCP. Medical treatment for prevention has been disappointing. Proper patient selection and pancreatic duct stenting have been shown to reduce the complication rate in randomized clinical trials.

Endoscopic retrograde cholangiopancreatography associated pancreatitis: A 15-year review.

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