دورية أكاديمية
أعرض في EDS

Efficacy of Epinephrine Injection in Preventing Post-ERCP Pancreatitis.

التفاصيل البيبلوغرافية
العنوان: Efficacy of Epinephrine Injection in Preventing Post-ERCP Pancreatitis.
المؤلفون: Torun S; Departments of Gastroenterology., Ödemiş B; Ankara City Hospital, Ankara., Çetin MF; General Surgery., Önmez A; Internal Medicine, School of Medicine, Duzce University, Duzce., Coşkun O; Department of Gastroenterology, School of Medicine, Amasya University, Amasya, Turkey.
المصدر: Surgical laparoscopy, endoscopy & percutaneous techniques [Surg Laparosc Endosc Percutan Tech] 2020 Oct 12; Vol. 31 (2), pp. 208-214. Date of Electronic Publication: 2020 Oct 12.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 100888751 Publication Model: Electronic Cited Medium: Internet ISSN: 1534-4908 (Electronic) Linking ISSN: 15304515 NLM ISO Abbreviation: Surg Laparosc Endosc Percutan Tech Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Hagerstown, MD : Lippincott Williams & Wilkins, c1999-
مواضيع طبية MeSH: Cholangiopancreatography, Endoscopic Retrograde*/adverse effects , Pancreatitis*/etiology , Pancreatitis*/prevention & control, Administration, Rectal ; Epinephrine ; Humans ; Retrospective Studies
مستخلص: Background: Rectal indomethacin or a topical spray of epinephrine to the papilla of Vater has each shown efficacy alone in the prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP). We supposed that a submucosal epinephrine injection would be more effective and longer acting than a topical epinephrine spray and therefore would further reduce the incidence of PEP.
Patients and Methods: A retrospective analysis was conducted of 412 patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) between January 2017 and December 2019. These patients were divided into 2 groups: the indomethacin group and the indomethacin plus the submucosal epinephrine injection group. The incidence rates and severity of PEP, post-ERCP hyperamylasemia, other outcomes, and any other adverse events were compared between the groups.
Results: Baseline demographic and clinical characteristics and procedure-related parameters were similar between the 2 groups. The incidence of PEP was 0.4% in the epinephrine group compared with 5.1% in the indomethacin group (P<0.001). Post-ERCP hyperamylasemia occurred in 24.6% of patients in the indomethacin group, whereas 7.6% of patients in the epinephrine group developed this condition; the difference was significant (P<0.001). Postsphincterotomy bleeding occurred in 5 patients, all of whom were in the indomethacin group (P<0.001). Other adverse events, including arrhythmias, acute coronary events, stroke, or hypertension were not significantly different between the 2 groups.
Conclusion: Addition of a submucosal epinephrine injection in conjunction with rectal indomethacin significantly reduced the incidence of PEP, post-ERCP hyperamylasemia, and postsphincterotomy bleeding.
Competing Interests: The author declares no conflicts of interest.
(Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.)
References: Andriulli A, Loperfido S, Napolitano G, et al. Incidence rates of post-ERCP complications: a systematic survey of prospective studies. Am J Gastroenterol. 2007;102:1781–1788.
Freeman ML, DiSario JA, Nelson DB, et al. Risk factors for post-ERCP pancreatitis: a prospective, multicenter study. Gastrointest Endosc. 2001;54:425–434.
Masci E, Toti G, Mariani A, et al. Complications of diagnostic and therapeutic ERCP: a prospective multicenter study. Am J Gastroenterol. 2001;96:417–423.
Akshintala VS, Hutfless SM, Colantuoni E, et al. Systematic review with network meta-analysis: pharmacological prophylaxis against post-ERCP pancreatitis. Aliment Pharmacol Ther. 2013;38:1325–1337.
Kubiliun NM, Adams MA, Akshintala VS, et al. Evaluation of pharmacologic prevention of pancreatitis after endoscopic retrograde cholangiopancreatography: a systematic review. Clin Gastroenterol Hepatol. 2015;13:1231–1239.
Vadala di Prampero SF, Faleschini G, Panic N, et al. Endoscopic and pharmacological treatment for prophylaxis against postendoscopic retrograde cholangiopancreatography pancreatitis: a meta-analysis and systematic review. Eur J Gastroenterol Hepatol. 2016;28:1415–1524.
Wang G, Xiao G, Xu L, et al. Effect of somatostatin on prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis and hyperamylasemia: a systematic review and meta-analysis. Pancreatology. 2018;18:370–378.
Cavallini G, Tittobello A, Frulloni L, et al. Gabexate for the prevention of pancreatic damage related to endoscopic retrograde cholangiopancreatography. N Engl J Med. 1996;335:919–923.
Tsujino T, Kawabe T, Omata M, et al. Antiproteases in preventing post-ERCP acute pancreatitis. J Pancreas. 2007;9:509–517.
Kaffes AJ, Bourke MJ, Ding S, et al. A prospective, randomized, placebo-controlled trial of transdermal glyceryl trinitrate in ERCP: effects on technical success and post-ERCP pancreatitis. Gastrointest Endosc. 2006;64:351–357.
Rabenstein T, Roggenbuck S, Framke B, et al. Complications of endoscopic sphincterotomy: can heparin prevent acute pancreatitis after ERCP? Gastrointest Endosc. 2002;55:476–483.
Devière J, Le Moine O, Van Laethem JL, et al. Interleukin 10 reduces the incidence of pancreatitis after therapeutic endoscopic retrograde cholangiopancreatography. Gastroenterology. 2001;120:498–505.
Pezzilli R, Romboli E, Campana D, et al. Mechanisms involved in the onset of post-ERCP pancreatitis. J Pancreas. 2002;3:162–168.
Ohashi A, Tamada K, Tomiyama T, et al. Epinephrine irrigation for the prevention of pancreatic damage after endoscopic balloon sphincteroplasty. J Gastroenterol Hepatol. 2001;16:568–571.
Matsushita M, Takakuwa H, Shimeno N, et al. Epinephrine sprayed on the papilla for prevention of post-ERCP pancreatitis. J Gastroenterol. 2009;44:71–75.
Nakaji K, Suzumura S, Nakae Y, et al. Effects in the control of edema of the papilla of vater by epinephrine saline irrigation after endoscopic retrograde cholangiopancreatography in an endoscopy center in Japan, 2003 to 2007: exploratory retrospective analysis to evaluate the characteristics of eligible patients with a focus on serum amylase levels. Intern Med. 2009;48:945–952.
Xu LH, Qian JB, Gu LG, et al. Prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis by epinephrine sprayed on the papilla. J Gastroenterol Hepatol. 2011;26:1139–1144.
Igawa M, Miyaoka M, Saitoh T. Influence of topical epinephrine application on microcirculatory disturbance in subjects with ulcerative colitis evaluated by laser Doppler flowmetry and transmission electron microscopy. Dig Endosc. 2000;12:126–130.
Chung SC, Leung JW, Leung FW. Effect of submucosal epinephrine injection on local gastric blood flow. A study using laser Doppler flowmetry and reflectance spectrophotometry. Dig Dis Sci. 1990;35:1008–1011.
Elmunzer BJ, Scheiman JM, Lehman GA, et al. A randomized trial of rectal indomethacin to prevent post-ERCP pancreatitis. N Engl J Med. 2012;366:1414–1422.
Elmunzer BJ, Higgins PD, Saini SD, et al. Does rectal indomethacin eliminate the need for prophylactic pancreatic stent placement in patients undergoing high-risk ERCP? Post hoc efficacy and costbenefit analyses using prospective clinical trial data. Am J Gastroenterol. 2013;108:410–415.
Cotton PB, Eisen GM, Aabakken L, et al. A lexicon for endoscopic adverse events: report of an ASGE workshop. Gastrointest Endosc. 2010;71:446–454.
Dumonceau JM, Kapral C, Aabakken L, et al. ERCP-related adverse events: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy. 2020;52:127–149.
Kamal A, Akshintala VS, Talukdar R, et al. A randomized trial of topical epinephrine and rectal indomethacin for preventing post-endoscopic retrograde cholangiopancreatography pancreatitis in highrisk patients. Am J Gastroenterol. 2019;114:339–347.
Menninger WC. The oral administration of epinephrine. Arch Intern Med. 1927;40:701–714.
Giragossintz G, Mackler H. The oral administration of adrenaline. Endocrinology. 1929;13:88–92.
Ferreira LE, Baron TH. Post-sphincterotomy bleeding: who, what, when, and how. Am J Gastroenterol. 2007;102:2850–2858.
Patel R, Varadarajulu S, Wilcox CM, et al. Endoscopic ampullectomy: techniques and outcomes. J Clin Gastroenterol. 2012;460:8–15.
المشرفين على المادة: YKH834O4BH (Epinephrine)
تواريخ الأحداث: Date Created: 20201013 Date Completed: 20211124 Latest Revision: 20211124
رمز التحديث: 20221213
DOI: 10.1097/SLE.0000000000000867
PMID: 33048897
قاعدة البيانات: MEDLINE
الوصف
تدمد:1534-4908
DOI:10.1097/SLE.0000000000000867