Volume : VIII, Issue : III, March - 2018

Incidence of post endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) in a new centre in the department of gastroenterology of Kurnool Medical college.

Dr. V. Venkata Ranga Reddy, Dr B. Shankara Sharma, Dr. G. Mohan Reddy

Abstract :

 

Introduction: Acute development of pancreatitis is a serious complication of ERCP procedure and it results in significant morbidity , occasional mortality and increased health–care expenditure.The chance of occurance of this devastating  complication varies from 3 to 15 percent of cases in various studies worldwide¹. About 5 percent of post ERCP pancreatitis will follow a severe course,requiring prolonged hospitalization ¹.

Aim: As the PEP is a life threatening complication, we aim to reduce it by following standard recommendations of various experts in the field of therapeutic  ERCP.

Methods and Materials: Total 280 patients of obstructive jaundice were thoroughly evaluated before either CT scan abdomen or MRCP was finally done before embarking on therapeutic ERCP for various etiological conditions of obstructive jaundice.The duration of study in the department of Gastroenterology is from june 2014 to till date. 137 of 280 cases were referred from other departments in the same hospital. After the ERCP, these patients were followed for any development of pancreatitis. 1.Only patients who underwent therapeutic ERCP considered for the study

2.Pancreatic – like pain and  hyperamylasaemia were evaluated either 6 to 8 hours or 24 hours after the procedure

3.Computed tomography   scan of  abdomen was performed in those patients with 24 – hour pancreatic pain associated with hyperamylasaemia more than three times the upper normal limit

4. Diagnosis of PEP was made according to standard Atlanta classification³,which mandates the presence of 2 of the three following features.

   a.Pain abdomen typical of Acute pancreatitis

  b.3–fold elevation of amylase / lipase

  c.Evidence of pancreatic inflammation on abdominal imaging³.

                      In order to decrease the incidence of of PEP, we strictly adopted the following approaches.

  a.Selective cannulation of common bile duct .

  b.In case of difficulty of cannulation of CBD, pre–cut sphincterotomy was done in 12 cases.

  c.Balloon dilation of  sphincter was not attempted.

  d.Pancreatography  was not done routinely.

Results: Three patients developed features of Acute pancreatitis as per the latest Atlanta classification³ for Acute pancreatitis.

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Article: Download PDF   DOI : 10.36106/ijar  

Cite This Article:

Dr.V.Venkata Ranga Reddy, Dr B.Shankara Sharma, Dr.G.Mohan Reddy, Incidence of post endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) in a new centre in the department of gastroenterology of Kurnool Medical college., INDIAN JOURNAL OF APPLIED RESEARCH : Volume-8 | Issue-3 | March-2018

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