Endoscopic sphincterotomy in the early treatment of acute pancreatitis

Article Abstract:

Early diagnosis of gallstones with endoscopic retrograde cholangiopancreatography (ERCP) may improve the outcome of patients with acute pancreatitis. Studies on the early surgical removal of gallstones in these patients have produced mixed results on its effectiveness in lowering the risk of death. Emergency endoscopic surgery following diagnosis with ERCP has been proposed as an alternative to conventional surgery. A recent Hong Kong study did not corroborate a previous British study which found that patients undergoing endoscopic surgery had lower rates of death and complications than patients receiving conventional treatment. The Hong Kong study did find, however, that endoscopic surgery prevented bacterial infections of the biliary tract. ERCP is essential for an accurate early diagnosis of gallstones, but until further studies are conducted, emergency endoscopic surgery may be warranted only for patients whose pancreatic attack is predicted to be severe, who do not respond to conservative treatment or who have a suspected case of acute cholangitis.

Editorial, Diagnosis, Surgery, Gallstones, Endoscopic surgery

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Gabexate for the prevention of pancreatic damage related to endoscopic retrograde cholangiopancreatography

Article Abstract:

Gabexate may prevent pancreatic damage in patients who have endoscopic retrograde cholangiopancreatography (ERCP). ERCP is a procedure used to diagnose pancreatic diseases. Of 418 patients scheduled for an ERCP, 208 received the protease inhibitor gabexate before the procedure and 210 received a placebo. Gabexate significantly reduced pancreatic enzyme levels indicative of pancreatic damage. Only 6% of those who received gabexate developed abdominal pain compared to 14% of the placebo group. Two percent of the gabexate group developed pancreatitis compared to 8% of the placebo group.

Prevention, Complications and side effects, Protease inhibitors

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