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Despite its relative safety (in comparison with surgery), and undoubted role in many clinical circumstances, biliary sphincterotomy is the most dangerous procedure routinely performed by endoscopists. Complications occur in about 10% of patients; 2 to 3% have a prolonged hospital stay, with a risk of dying. This document is an attempt to provide guidelines(More)
BACKGROUND Complications of ERCP are an important concern. We sought to determine predictors of post-ERCP complications at our institution. METHODS GI TRAC is a comprehensive data set of patients who underwent ERCP at our institution from 1994 through 2006. Logistic regression models were used to evaluate 4 categories of complications: (1) overall(More)
CONTEXT Conventional colonoscopy is the best available method for detection of colorectal cancer; however, it is invasive and not without risk. Computed tomographic colonography (CTC), also known as virtual colonoscopy, has been reported to be reasonably accurate in the diagnosis of colorectal neoplasia in studies performed at expert centers. OBJECTIVE To(More)
Terminology in classification of pancreatograms was discussed at a recent international workshop on chronic pancreatitis. A new terminology based on morphological radiographic appearances and a new classification to describe the severity and localisation of pancreatogram changes were agreed. Pancreatograms in chronic pancreatitis are graded as normal or(More)
BACKGROUND Technical options for pancreatic sphincterotomy of the minor papilla for pancreas divisum include a needle-knife cut over a plastic stent and a standard pull-type cut with a sphincterotome. OBJECTIVE Our objective was to compare the frequency, safety, and intermediate-term efficacy of these 2 techniques at our institution. PATIENTS AND(More)
Intragastric bacterial colonization is well known in pernicious anaemia (PA), but its consequences have rarely been investigated. We have studied the clinical history, blood samples, and endoscopic biopsies from the stomach and duodenum of 80 patients with PA. In a random subgroup of 22 patients gastric juice was collected for aerobic culture and for(More)
BACKGROUND AND STUDY AIMS The most permanent method of treating achalasia is a surgical myotomy. Because of the requirement for a mucosal incision and the risk of perforation, this procedure has not generally been approached endoscopically. We hypothesized that we could perform a safe and robust myotomy by working in the submucosal space, accessed from the(More)
OBJECTIVES We have reviewed the results of endoscopic stenting with and without sphincterotomy at the minor papilla in 34 patients with pancreas divisum and pain or pancreatitis. METHODS Symptoms before and after the procedure were scored and compared, as was the patient's estimate of the overall effectiveness of the treatment. RESULTS A statistically(More)
OBJECTIVES To assess the long-term outcomes of endoscopic minor papilla therapy in a spectrum of symptomatic patients with pancreas divisum. METHODS Patients with pancreas divisum coded in a prospective database as having had minor papilla endotherapy (July 1997-May 2003, n = 145) were grouped into 3 categories: (1) acute recurrent pancreatitis, (2)(More)
BACKGROUND & AIMS Patients with sphincter of Oddi dysfunction are at high risk of developing pancreatitis after endoscopic biliary sphincterotomy. Impaired pancreatic drainage caused by pancreatic sphincter hypertension is the likely explanation for this increased risk. A prospective, randomized controlled trial was conducted to determine if ductal drainage(More)