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Post–endoscopic retrograde cholangiopancreatography pancreatitis: Overview and pathophysiology
Endoscopic retrograde cholangiopancreatography is a widely used therapeutic endoscopic procedure with small risk of complications. The most common and dreadful complication is post–endoscopic retrograde cholangiopancreatography pancreatitis (PEP). Concerning the definition of PEP itself and classification of its severity, there is still some ambiguity. The most commonly used definition is the one proposed in the 1991 consensus, although there are indications that the current clinical definition and the 2 new severity classifications, namely the revised Atlanta classification and the determinant-based classification are m...
Source: Techniques in Gastrointestinal Endoscopy - September 30, 2014 Category: Gastroenterology Authors: Efstratios I. Koutroumpakis, Georgios I. Papachristou Source Type: research

Post-endoscopic Retrograde Cholangiopancreatography Pancreatitis: Overview and Pathophysiology
Endoscopic retrograde cholangiopancreatography (ERCP) is a widely used therapeutic endoscopic procedure with small risk of complications. The most common and dreadful complication is post-ERCP pancreatitis (PEP). Concerning the definition of PEP itself and classification of its severity, there is still some ambiguity. The most commonly used definition is the one proposed in the 1991 consensus, although there are indications that the current clinical definition and the two new severity classifications, namely the revised Atlanta (RAC) and the Determinant-Base Classification (DBC) are more accurate in diagnosing and classify...
Source: Techniques in Gastrointestinal Endoscopy - September 30, 2014 Category: Gastroenterology Authors: Efstratios I Koutroumpakis, Georgios I Papachristou Source Type: research

Introduction
Despite recent innovations that have significantly transformed the field of interventional endoscopy, endoscopic retrograde cholangiopancreatography (ERCP) remains the most dangerous procedure routinely performed by gastrointestinal endoscopists. The risk profile of ERCP is broad, and complications related to this procedure may lead to substantial patient suffering, an occasional procedure-related death, increased endoscopist stress, and ultimately litigation. Eliminating or mitigating ERCP-related adverse events has been a consistent clinical and research priority for more than 3 decades. (Source: Techniques in Gastrointestinal Endoscopy)
Source: Techniques in Gastrointestinal Endoscopy - September 25, 2014 Category: Gastroenterology Authors: B. Joseph Elmunzer Source Type: research

Stent as bridge to surgery in patients with malignant large bowel obstruction
Self-expandable metal stents (SEMSs) have been used in the management of colorectal obstruction as an alternative to emergency surgery. The stent as a bridge to surgery is a preoperative modality for the relief of acute obstruction so that resection can be done on an elective basis after stabilization of the acute illness and bowel preparation. Using PubMed, a literature search regarding the outcomes, mortality, morbidity, and long-term prognosis of SEMS׳s use as a bridge to surgery in colorectal obstruction was undertaken. (Source: Techniques in Gastrointestinal Endoscopy)
Source: Techniques in Gastrointestinal Endoscopy - September 5, 2014 Category: Gastroenterology Authors: Vincenzo Cennamo Source Type: research

The Stent as Bridge to Surgery in Patients with Malignant Large Bowel Obstruction
Self-expandable metal stents (SEMS) have been used in the management of colorectal obstruction as an alternative to emergency surgery. The stent as bridge to surgery is a preoperative modality for the relief of acute obstruction so that resection can be done on an elective basis after stabilization of the acute illness and bowel preparation. Using PubMed, a literature search regarding the outcomes, mortality, morbidity and long-term prognosis of SEMS's use as a bridge to surgery in colorectal obstruction was undertaken. (Source: Techniques in Gastrointestinal Endoscopy)
Source: Techniques in Gastrointestinal Endoscopy - September 5, 2014 Category: Gastroenterology Authors: Vincenzo Cennamo Source Type: research

Stent for palliation of advanced colorectal cancer
In palliation of advanced colorectal cancer, self-expanding metal stent (SEMS) can be an alternative to surgical resection for malignant obstruction proximal to the splenic flexure. SEMS is recommended as the preferred treatment for palliation of left-sided advanced malignant colonic obstruction with a high quality of evidence, except in patients (1) with a presumed long life expectancy (>1 year) and (2) treated or considered for treatment with antiangiogenic drugs (ie, bevacizumab). The validity of the recommendation that palliative stenting is contraindicated in patients with a presumed long life expectancy (>1 year) bec...
Source: Techniques in Gastrointestinal Endoscopy - September 5, 2014 Category: Gastroenterology Authors: Søren Meisner Source Type: research

Preface
Colonic endoprosthetics, particularly self-expandable metal stents (SEMSs), have been implanted for well over 20 years. It is sufficient to say the application of stent technology is now mature. However, to place it in perspective, colonic stents have gone through phases commonly seen with new technologies. The early phase in the early 1990s with preliminary descriptions of stent placement for malignant colonic obstruction was met with enthusiasm by endoscopists and with trepidation and resistance by colorectal surgeons. (Source: Techniques in Gastrointestinal Endoscopy)
Source: Techniques in Gastrointestinal Endoscopy - August 28, 2014 Category: Gastroenterology Authors: Todd H. Baron, Alessandro Repici Source Type: research

The evolution of surgery for the treatment of malignant large bowel obstruction
Large bowel obstruction (LBO) secondary to malignancy is an urgent or emergent surgical condition. Despite recent advances in alternative therapies, surgery remains the primary evidence-based curative, palliative, or temporizing treatment option. Acute presentations of malignant LBO are likely to be associated with advanced age, multiple comorbidities, advanced disease stage, and a poor prognosis. Immediate management should focus on prompt diagnosis, resuscitation, and treatment to relieve the obstruction. (Source: Techniques in Gastrointestinal Endoscopy)
Source: Techniques in Gastrointestinal Endoscopy - August 14, 2014 Category: Gastroenterology Authors: Sameer K. Sharma, Jeffrey W. Milsom Source Type: research

Endoprosthetics in the treatment of benign esophageal strictures
Benign esophageal strictures are a common problem in endoscopic practice. The predominant symptom of patients is dysphagia. The initial treatment option for a benign esophageal stricture is dilation. A small subgroup of strictures, that is, those that are long (>2cm), are tortuous, and have a narrow diameter, or are associated with caustic or postradiotherapy etiology, tend to recur and are therefore called refractory. Temporary stent placement, with either a self-expandable metal stent or a self-expandable plastic stent, can be considered as a treatment option in these patients. (Source: Techniques in Gastrointestinal Endoscopy)
Source: Techniques in Gastrointestinal Endoscopy - August 14, 2014 Category: Gastroenterology Authors: Alessandro Repici, Chiara Genco, Ivana Bravatà, Andrea Anderloni Source Type: research

Perforation due to ERCP
Iatrogenic duodenal and pancreaticobiliary perforations associated with endoscopic retrograde cholangiopancreatography (ERCP) are rare but associated with a significant morbidity and mortality. Perforations can be caused by the endoscope itself, secondary to endoscopic sphincterotomy, or related to the use of accessories (guidewires and stents). There is no consensus to direct the clinician on proper management of ERCP-related perforation. Traditionally perforations were classified according to their etiology and anatomical site and managed accordingly. (Source: Techniques in Gastrointestinal Endoscopy)
Source: Techniques in Gastrointestinal Endoscopy - August 8, 2014 Category: Gastroenterology Authors: Vivek Kumbhari, Mouen A. Khashab Source Type: research

Infectious complications of endoscopic retrograde cholangiopancreatography (ERCP)
Endoscopic retrograde cholangiopancreatography (ERCP), performed for the diagnosis and treatment of many conditions of the bile ducts and the pancreas, can result in complications, including infectious ones, such as sepsis, cholangitis, cholecystitis, liver abscess, infected pancreatic pseudocyst, endocarditis, and perforation. It is important for the clinician to be knowledgeable about the most common infectious complications of ERCP to quickly and accurately identify and manage them. Here, we review these complications highlighting the risk factors, presentation, and management, as well as the recommended strategies to h...
Source: Techniques in Gastrointestinal Endoscopy - August 6, 2014 Category: Gastroenterology Authors: Stephanie Judd, Fadi Antaki Source Type: research

Outcome and complications of stenting for malignant obstruction
Malignant colorectal obstruction is not an uncommon clinical condition as it is frequently cited that obstruction occurs in 7%-29% of patients with colorectal cancer. The severity of this condition is illustrated by its high postoperative mortality (up to 24%) and morbidity (up to 78%) rates after these patients have undergone conventional emergency resection of the obstructing tumor. In the past decade, the application of self-expandable metal stents (SEMSs) as treatment of malignant large bowel obstruction has expanded rapidly to reduce these alarming numbers by ‘bridge to surgery’ treatment from an emergency to an e...
Source: Techniques in Gastrointestinal Endoscopy - August 6, 2014 Category: Gastroenterology Authors: Emo E. van Halsema, Jeanin E. van Hooft Source Type: research

Rare and underappreciated complications of endoscopic retrograde cholangiopancreatography
Endoscopic retrograde cholangiopancreatography has evolved to a largely therapeutic procedure for the management of a variety of benign and malignant disorders of the pancreas and biliary tree. Although the most commonly implicated adverse events include pancreatitis, postsphincterotomy hemorrhage and perforation, cardiopulmonary issues (such as aspiration), and infection, there are a multitude of rare and often underappreciated complications that may occur. These are often related to endoscope manipulation, air insufflation, endoscopic retrograde cholangiopancreatography devices, and iodinated contrast. (Source: Technique...
Source: Techniques in Gastrointestinal Endoscopy - July 31, 2014 Category: Gastroenterology Authors: Ji Young Bang, Gregory A. Coté Source Type: research

Rare and underappreciated complications of ERCP
Endoscopic retrograde cholangiopancreatography (ERCP) has evolved to a largely therapeutic procedure for the management of a variety of benign and malignant disorders of the pancreas and biliary tree. While the most commonly implicated adverse events include pancreatitis, post-sphincterotomy hemorrhage and perforation, cardiopulmonary issues (such as aspiration), and infection, there are a multitude of rare and often underappreciated complications that may occur. These are often related to endoscope manipulation, air insufflation, ERCP devices, and iodinated contrast. (Source: Techniques in Gastrointestinal Endoscopy)
Source: Techniques in Gastrointestinal Endoscopy - July 31, 2014 Category: Gastroenterology Authors: Ji Young Bang, Gregory A. Coté Source Type: research

Cardiopulmonary complications of endoscopic retrograde cholangiopancreatography
Cardiopulmonary complications account for up to 16% of endoscopic retrograde cholangiopancreatography (ERCP)–related adverse events. They have a reported incidence in large prospective studies ranging from 0.07%-2.4% but have been reported much more frequently in smaller single-center studies. This discrepancy in rates is probably because of lack of consensus definitions and inconsistent documentation owing to their often transient nature. Minor complications such as brief arrhythmias, transient desaturation, or fluctuation in blood pressure are frequent but may be of little clinical significance. (Source: Techniques in ...
Source: Techniques in Gastrointestinal Endoscopy - July 29, 2014 Category: Gastroenterology Authors: Saurabh Chawla, Field F. Willingham Source Type: research