Bauchspeicheldrüse (Pankreas)

Bauchspeicheldrüse (Pankreas)

ASGE Journal Scan | Bauchspeicheldrüse (Pankreas)

Both Balloon Enteroscopy ERCP and EUS-Guided Antegrade Treatment Are Reasonable Options for Choledocholithiasis After Roux-en-Y Gastrectomy

Managing choledocholithiasis in patients after Roux-en-Y gastrectomy is challenging, and with no excluded stomach, endoscopic ultrasound (EUS)-guided transmural lumen-apposing metal stent placement is significantly more

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ASGE Journal Scan | Bauchspeicheldrüse (Pankreas)

Performance of Published Criteria in Predicting Choledocholithiasis in Practice

Choledocholithiasis can be identified through multiple means, including a right upper quadrant ultrasound, endoscopic ultrasound (EUS), endoscopic retrograde cholangiography (ERCP), magnetic resonance cholangiopancreatography (MRCP), and

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ASGE Journal Scan | Bauchspeicheldrüse (Pankreas)

Pure Cut Current for Biliary Sphincterotomy Is Associated With Less Delayed Bleeding and May Reduce Post-ERCP Pancreatitis Risk

Thermal injury from biliary sphincterotomy is thought to play a role in at least a proportion of post-ERCP pancreatitis (PEP) cases. Thus, the present study

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ASGE Journal Scan | Bauchspeicheldrüse (Pankreas)

Large Single-Use Duodenoscope Experience Shows High Success and Low Crossover Rates

Single-use duodenoscopes were developed to eliminate the risk of duodenoscope-associated transmission of infections. However, there are concerns that the performance of single-use duodenoscopes may not

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ASGE Journal Scan | Bauchspeicheldrüse (Pankreas) | Magen und Dünndarm

Is Digital Gut-Directed Hypnotherapy Better Than Muscle Relaxation in Patients With Irritable Bowel Syndrome?

In addition to dietary modification and pharmacologic therapy, behavioral therapy has become a recognized treatment for irritable bowel syndrome (IBS) and is now integrated into

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ASGE Journal Scan | Bauchspeicheldrüse (Pankreas)

More Evidence for Early Cholecystectomy After Gallstone Pancreatitis

Same-admission cholecystectomy is recommended for patients with mild gallstone pancreatitis (GSP) to reduce recurrent GSP events and lower costs. However, adherence to same-admission cholecystectomy remains

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Bauchspeicheldrüse (Pankreas)

Fluoroscopy-Free ERCP for Choledocholithiasis Is Safe and Effective in a Pilot Study

In select patients – most commonly during pregnancy – using a fluoroscopy-free approach to stone removal is preferred. Given some initial success with this approach

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ASGE Journal Scan | Bauchspeicheldrüse (Pankreas)

Lessons Learned After Post-ERCP Mortality

ERCP is a vital endoscopic procedure for the management of pancreatobiliary disease but is associated with serious adverse events, including mortality. Although a central tenet

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ASGE Journal Scan | Bauchspeicheldrüse (Pankreas)

Effectiveness of EUS Gallbladder Drainage as Primary Therapy for Malignant Biliary Obstruction

ERCP is generally the first-line approach for palliation of distal malignant biliary obstruction (DMBO), but interest in the use of endoscopic ultrasound (EUS)-guided transmural drainage

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ASGE Journal Scan | Bauchspeicheldrüse (Pankreas)

Fully Covered Self-Expanding Metal Stents Are Safe and May Be More Durable in Distal Malignant Biliary Obstruction

It is clear that metal stents are superior to plastic stents for palliation of distal malignant biliary obstruction (dMBO). Among self-expanding metal stents (SEMS), there

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ASGE Journal Scan | Bauchspeicheldrüse (Pankreas)

Primary EUS Choledochoduodenostomy Is Safe and Efficacious in Malignant Biliary Obstruction

Palliation of malignant biliary obstruction is required to facilitate oncologic therapy and relief of symptoms. Although this is almost always performed with ERCP, biliary cannulation

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ASGE Journal Scan | Bauchspeicheldrüse (Pankreas)

Consensus Guidelines Recommend Monitored Anesthesia Care for Most ERCPs

Adequate patient sedation is essential for the successful completion of ERCP; however, delivery methods of anesthesia vary between providers, with most endoscopists favoring deep sedation

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ASGE Journal Scan | Bauchspeicheldrüse (Pankreas)

Papillary Morphology Predicts Difficult Biliary Cannulation

Successful and safe ERCP requires the endoscopist to cannulate the duct of interest successfully and efficiently. Although operator skill clearly influences procedure success, there is

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ASGE Journal Scan | Bauchspeicheldrüse (Pankreas)

True Rate of Post-ERCP Pancreatitis: Do Randomized Trials Provide the Answer?

Pancreatitis after ERCP is one of the most common and morbid adverse events following any gastrointestinal endoscopy procedure. It is imperative that the consent process

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ASGE Journal Scan | Bauchspeicheldrüse (Pankreas)

Might Biliary Radiofrequency Ablation Be Less Effective Than We Thought?

Most inoperable malignant biliary strictures are best treated with self-expanding metal stents (SEMS); however, a significant portion of patients develop stent occlusion from neoplastic or

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ASGE Journal Scan | Bauchspeicheldrüse (Pankreas)

Empiric Prophylactic Plastic Stenting for Disconnected Pancreatic Duct After Necrosectomy Is Not Uniformly Beneficial

Pancreatic necrosis often results in main pancreatic duct injury and eventual discontinuity, or so-called disconnected pancreatic duct syndrome (DPDS), with recurrent symptoms from duct obstruction

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ASGE Journal Scan | Bauchspeicheldrüse (Pankreas)

ASGE Guideline on Screening for Pancreatic Cancer in High-Risk Cohorts

Pancreatic ductal adenocarcinoma (PDAC) continues to have a dismal prognosis at the time of presentation. Survival is improved with diagnosis at an early stage, but

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ASGE Journal Scan | Bauchspeicheldrüse (Pankreas)

Examining Cost-Utility Data for Interventions to Prevent Infection Transmission by Duodenoscopes

Transmission of multidrug-resistant organisms between patients undergoing ERCP prompted the U.S. Food and Drug Administration to issue guidance for endoscopy departments to adopt intensified reprocessing

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ASGE Journal Scan | Bauchspeicheldrüse (Pankreas)

Electrohydraulic Lithotripsy Safe and Effective for Clearing Obstructive Pancreatic Stones Near the Duodenum

Electrohydraulic lithotripsy (EHL) and laser lithotripsy are both well-established methods for the treatment of biliary and genitourinary stones. Several retrospective series have described successful pancreatoscopy-guided

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ASGE Journal Scan | Bauchspeicheldrüse (Pankreas)

Cholecystectomy Optimally Performed Within 8 Weeks for Necrotizing Biliary Pancreatitis

Cholecystectomy before hospital dismissal is advised for most cases of acute biliary pancreatitis (ABP). Surgery is often delayed in the setting of pancreatic necrosis to

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ASGE Journal Scan | Bauchspeicheldrüse (Pankreas)

Further Validation for a Motorized Endoscopic Necrosectomy Device

Many patients with walled-off pancreatic necrosis (WON) require debridement following minimally invasive drainage. This often entails serial procedures with cumulative expense and risk. These authors

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ASGE Journal Scan | Bauchspeicheldrüse (Pankreas)

Surveillance Rather Than Immediate Resection Appears Advisable for Most Familial Adenomatous Polyposis-Related Ampullary Adenomas

Ampullary, periampullary, and duodenal adenomas commonly occur in familial adenomatous polyposis (FAP). Their detection and management are fraught with challenges related to balancing the risk

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ASGE Journal Scan | Bauchspeicheldrüse (Pankreas)

Incision Improves Success and Safety for Difficult Biliary Access Compared With Wire- or Stent-Guided Entry

A variety of techniques have been described for achieving deep biliary cannulation, a necessary prelude to most endoscopic retrograde cholangiographic (ERCP) procedures. The rate of

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ASGE Journal Scan | Bauchspeicheldrüse (Pankreas)

On Balance, Benefit of Sphincterotomy for Biliary Stenting Appears to Outweigh the Risk

Limited reports have suggested that endoscopic biliary sphincterotomy (ES) at the time of transpapillary biliary stent placement may reduce the risk of post-ERCP pancreatitis (PEP).

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ASGE Journal Scan | Bauchspeicheldrüse (Pankreas)

Are There Signs or Symptoms That Predate the Diagnosis of Pancreatic Cancer?

Pancreatic ductal adenocarcinoma (PDAC) is the third leading cause of cancer mortality since most cancers are advanced at diagnosis. Early identification of these cancers is

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ASGE Journal Scan | Bauchspeicheldrüse (Pankreas)

DNA Methylation Studies of Biliary Brush Cytology Samples Likely to Aid in Diagnosis of Cholangiocarcinoma

Establishing a firm diagnosis for indeterminate biliary strictures is often challenging. The current standard of practice is fluoroscopic and cholangioscopic characterization with brush and biopsy

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ASGE Journal Scan | Bauchspeicheldrüse (Pankreas)

BILE Criteria to Assess ERCP Need in Cholangitis May Be More Sensitive, Less Cumbersome Than Others

Biliary obstruction with associated cholangitis usually is managed with the use of endoscopic retrograde cholangiopancreatography (ERCP) for stone extraction or stent decompression of the bile

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ASGE Journal Scan | Bauchspeicheldrüse (Pankreas)

Covered Metal Stents Equal to Multiple Plastic Stents for Treatment of Biliary Strictures From Chronic Pancreatitis but Require Fewer Procedures

Compression of the distal bile duct within a fibrotic pancreas is one complication of chronic pancreatitis (CP), which can lead to chronic cholestasis, cholangitis, and

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ASGE Journal Scan | Bauchspeicheldrüse (Pankreas)

Transpapillary Gallbladder Stent Placement Usually Successful as Destination Therapy

Severe acute cholecystitis (AC) often is palliated with percutaneous or endoscopic drainage 6 to 12 weeks prior to preplanned interval cholecystectomy. Many patients with severe

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ASGE Journal Scan | Bauchspeicheldrüse (Pankreas)

Radiofrequency Ablation Plus Stent Placement for Extrahepatic Cholangiocarcinoma Shows Benefit Over Stenting Alone

The optimal treatment for cholangiocarcinoma (CCA) or ampullary carcinoma (AC) is surgery. When deemed unresectable and not amenable to neoadjuvant therapy followed by liver transplantation,

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ASGE Journal Scan | Bauchspeicheldrüse (Pankreas)

Better, but Insufficient Results From Duodenoscope Reprocessing With Double Wash and High-Level Disinfection or Liquid Chemical Sterilization

The potential for interpatient transmission of infections by contaminated duodenoscopes is a significant concern in the practice of ERCP. Pending further understanding and development of

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ASGE Journal Scan | Bauchspeicheldrüse (Pankreas)

Cholecystectomy Before Dismissal Confirmed as Optimal in Large Population of Veterans With Biliary Pancreatitis

Multiple guidelines recommend performing cholecystectomy (CCy) before hospital dismissal for patients with mild gallstone pancreatitis that is not complicated by infection or necrosis. In this

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ASGE Journal Scan | Bauchspeicheldrüse (Pankreas)

Hydrogen Peroxide, One Way or Another, Appears Beneficial During Endoscopic Necrosectomy

Management of walled-off pancreatic necrosis often benefits from direct transmural endoscopic necrosectomy. This retrospective chart review assessed the utility of hydrogen peroxide (H2O2) lavage as

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ASGE Journal Scan | Bauchspeicheldrüse (Pankreas)

Best Conformation for Hilar Self-Expanding Metal Stents Remains Undefined

Bilateral placement of metal stents for malignant hilar strictures (MHS) can be challenging. Two approaches have been used, each with potential benefits and challenges.  In

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ASGE Journal Scan | Bauchspeicheldrüse (Pankreas)

Updated Criteria for Prediction of Choledocholithiasis Add Specificity

A variety of recommendations have been proposed for predicting choledocholithiasis based upon presenting signs, symptoms, initial laboratory studies, and imaging. In this retrospective study, the

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ASGE Journal Scan | Bauchspeicheldrüse (Pankreas)

Further Evidence Supporting Early, Primary Use of Precut Sphincterotomy for Duct Access

Deep access to the bile duct or the pancreatic duct is required in order to complete all subsequent therapeutic ERCP maneuvers. Precut sphincterotomy (PCS) refers

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ASGE Journal Scan | Bauchspeicheldrüse (Pankreas)

Endoscopic Approaches to Drainage for Acute Cholecystitis Are Optimal in Nonoperative Patients

Gallbladder removal or drainage is a key component of treatment for acute cholecystitis. When the risk of urgent cholecystectomy is considered prohibitive, the optimal alternative

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ASGE Journal Scan | Bauchspeicheldrüse (Pankreas)

First Single-Use Duodenoscope Measures up in Direct Comparison for Low-Complexity Procedures

The development of single-use (disposable) endoscopes is one approach to eliminating infection transmission between sequential patients during endoscopy. This single-center study randomized patients undergoing endoscopic

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ASGE Journal Scan | Bauchspeicheldrüse (Pankreas)

Large-Caliber Dilation Without Sphincterotomy Is Efficacious and Safe for Stones >10 mm

Endoscopic biliary sphincterotomy (ES) is the standard prelude to duct stone removal; however, it carries moderate risk for both pancreatitis and bleeding and can be

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ASGE Journal Scan | Bauchspeicheldrüse (Pankreas)

Pancreatic Extracorporeal Shock Wave Lithotripsy: Efficient and Effective in Gastroenterologists’ Hands

Extracorporeal shock wave lithotripsy (ESWL) has become the dominant therapy for the treatment of symptomatic pancreatic duct stone obstruction in chronic calcific pancreatitis. In the

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ASGE Journal Scan | Bauchspeicheldrüse | Bauchspeicheldrüse (Pankreas)

Video Auditing of Duodenoscope Reprocessing Contributes to High Performance in a Tertiary Care Center

Lapses in reprocessing of flexible endoscopes have been demonstrated in many environments and are thought to contribute to the transmission of infection between patients.  The

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ASGE Journal Scan | Bauchspeicheldrüse | Bauchspeicheldrüse (Pankreas)

Urgent Early Pancreatic Drainage Is Safe and Effective

Endoscopic decompression and drainage of immature pancreatic and peripancreatic fluid collections with incomplete encapsulation by a wall of surrounding tissue have generally been avoided out

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Bauchspeicheldrüse (Pankreas) | Literatur

Metallstents zur Pankreaszysten-Drainage – gleicher Erfolg, mehr Komplikationen?

Die endosonographische Pankreaszystendrainage hat sich weltweit als Standard gegenüber anderen Vorgehensweisen durchgesetzt (perkutane Drainage, Operation). Im allgemeinen werden zwei Plastikstents, oft pigtail-Stents platziert und diese

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Bauchspeicheldrüse (Pankreas) | Literatur | Oberer GI-Trakt | Unterer GI-Trakt

Neues von der DDW 2017

Wie in jedem Jahr wurden auf der DDW in Chicago die neuesten Entwicklungen im Bereich Gastroenterologie und Endoskopie gezeigt, wobei in den letzten Jahren die

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Bauchspeicheldrüse (Pankreas) | ERCP | Literatur

Zweifel an der Wirksamkeit von NSAR gegen die Post-ERCP-Pankreatitis ?

Der Einsatz von nicht-steroidalen Antirheumatika (NSAR) wie zum Beispiel Indometacin oder Diclofenac zur Prävention der post-ERCP-Pankreatitis (PEP) wurde durch zahlreiche Studien weltweit belegt obwohl nicht

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Bauchspeicheldrüse (Pankreas) | Besondere Fälle | Lehrvideos | Oberer GI-Trakt

Endoskopische Therapie von Verhalten und Nekrosen nach schwerer nekotisierender Pankreatitis

Endoskopische Punktion & Nekrosektomie einer infizierten Pankreaspseudocyste mit dem AXIOS System. Herr Professor Meining aus Ulm zeigt die Therapie einer infizierten Pankreaspseudocyste, die unter endosonographischer

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Bauchspeicheldrüse (Pankreas) | Literatur

Seröse Cystadenome des Pankreas – auch weiterhin harmlos?

Cystische Pankreastumoren werden durch verbesserte und vor allem „Vorsorge“-Bildgebung zunehmend in asymptomatischem Stadium entdeckt und führen dann häufig zu differentialdiagnostischen Problemen. Geht keine Pankreatitis voraus

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