Abstract
ERCP prior to pancreaticoduodenectomy is unnecessary in select patients. When performed, it should be in conjunction with endoscopic ultrasound (EUS) to increase diagnostic sensitivity and allow for metal stent placement. The aim of this study was to determine differences in endoscopic practice patterns at community medical centers (CMC) and a comprehensive pancreaticobiliary referral center (PBRC). Retrospective cohort study of all patients seen at a PBRC for endoscopic and/or surgical management of potentially resectable malignant distal biliary obstruction from 1/2011 to 6/2014. Of 75 patients, 30 underwent endoscopic management at a CMC and 45 were initially managed at our PBRC. ERCP was attempted in 92% of patients. EUS was performed more frequently (100% vs. 13.3 %, P < 0.0001), ERCP was more successful (93% vs. 69%, P = 0.02), and metal stent placement more likely (41% vs. 5%, P = 0.005) at our PBRC compared to a CMC. The majority (81%) of patients undergoing initial endoscopy at a CMC required repeat endoscopy at our PBRC. Patients who are candidates for pancreaticoduodenectomy frequently undergo ERCP. At a CMC, ERCP is often unsuccessful, is rarely accompanied by EUS, and often requires repeat endoscopy. Our findings s...Continue Reading
References
Dec 20, 2005·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Victor K ChenTodd H Baron
May 31, 2006·Gastrointestinal Endoscopy·Claes Soderlund, Stefan Linder
Mar 16, 2007·Endoscopy·M KahalehP Yeaton
Apr 4, 2008·Gastrointestinal Endoscopy·William A RossJeffrey H Lee
Jan 15, 2010·The New England Journal of Medicine·Niels A van der GaagDirk J Gouma
Jan 15, 2010·The New England Journal of Medicine·Todd H Baron, Richard A Kozarek
Feb 25, 2010·Journal of Clinical Gastroenterology·Brian R BoulayStuart R Gordon
Aug 26, 2010·Gastroenterology·Pari Shah, Nuzhat A Ahmad
Feb 9, 2011·Journal of Clinical Gastroenterology·Harry R AslanianUzma D Siddiqui
Dec 20, 2012·European Journal of Gastroenterology & Hepatology·Yan-Liu ChuJuan Zhang
Dec 22, 2012·Digestive Diseases·Yasunori Minami, Masatoshi Kudo
Jan 22, 2013·Journal of Surgical Oncology·Amanda V HaymanDavid J Bentrem
Apr 3, 2013·The American Journal of Gastroenterology·Lianne K CavellMark A Schattner
Feb 25, 2014·Gastrointestinal Endoscopy·Frank WeilertJanak N Shah
Jun 4, 2014·Tumour Biology : the Journal of the International Society for Oncodevelopmental Biology and Medicine·Hongyu LiXiaozhong Guo
Jul 11, 2014·Current Opinion in Gastroenterology·Todd H Baron
Dec 3, 2014·Gastrointestinal Endoscopy·Phillip S GeV Raman Muthusamy
Dec 7, 2014·Gastrointestinal Endoscopy·Douglas G AdlerSachin Wani
Mar 21, 2015·Gastroenterology·Daisy WalterPeter D Siersema
Citations
Apr 5, 2016·Journal of Surgical Oncology·Daniel E Abbott
Jun 6, 2018·BMC Gastroenterology·Jihye KimJoo Sung Kim
Dec 31, 2020·Journal of Personalized Medicine·Torsten Beyna, Christian Gerges
May 1, 2021·Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver·Yunxiao LyuYuan Wang