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Related Concept Videos

Endoscopic Procedures V: ERCP01:26

Endoscopic Procedures V: ERCP

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Endoscopic Retrograde Cholangiopancreatography (ERCP) is a diagnostic procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions related to the bile ducts, pancreatic ducts, and gallbladder. This procedure is beneficial for identifying and addressing blockages, gallstones, strictures, and tumors within the biliary or pancreatic systems. ERCP is both diagnostic and therapeutic, offering the ability to visualize and treat identified problems in one session.
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Endoscopic Studies II: Thoracocentesis01:26

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Thoracentesis(Thoracocentesis), commonly known as pleural tap, is a medical procedure where a 22 gauge needle is inserted into the pleural space, the area between the lung and chest wall. This procedure is commonly performed to diagnose or treat various respiratory disorders.
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Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy01:26

Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy

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Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
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Esophageal Varices-II: Clinical Features and Management01:28

Esophageal Varices-II: Clinical Features and Management

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Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
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Related Experiment Video

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Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
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Bedside Biliary Drainage without Fluoroscopy for Critically Ill Patients.

Junbo Hong1, Wei Zuo2, Xiaodong Zhou1

  • 1Departments of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, 330006 Jiangxi Province, China.

Biomed Research International
|July 7, 2020
PubMed
Summary

Radiation-free endoscopic retrograde cholangiopancreatography (ERCP) is effective for critically ill patients needing biliary drainage. Endoscopic nasobiliary drainage (ENBD) may offer better outcomes than endoscopic retrograde biliary drainage (ERBD).

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Area of Science:

  • Gastroenterology
  • Critical Care Medicine
  • Interventional Endoscopy

Background:

  • Bedside biliary drainage in intensive care unit (ICU) patients via ERCP without fluoroscopy presents significant challenges.
  • Evaluating the efficacy and safety of radiation-free ERCP is crucial for this vulnerable patient population.

Purpose of the Study:

  • To assess the effectiveness and safety of performing ERCP without radiation for critically ill patients requiring bedside biliary drainage.
  • To compare outcomes between different drainage methods in this high-risk group.

Main Methods:

  • Retrospective analysis of consecutive ICU patients with severe pancreaticobiliary disorders undergoing bedside radiation-free ERCP.
  • Data collected included cannulation success, drainage success, adverse events, and 30-day mortality.

Main Results:

  • Radiation-free ERCP achieved successful cannulation in 93.75% and biliary drainage in 92.5% of 80 patients.
  • Mild post-ERCP pancreatitis occurred in only one patient; 30-day mortality was 36.25%.
  • Endoscopic nasobiliary drainage (ENBD) showed lower mortality (20%) compared to endoscopic retrograde biliary drainage (ERBD) (40.7%). Higher APACHE II scores (>22) were independent risk factors for mortality.

Conclusions:

  • Radiation-free ERCP is an effective and safe method for bedside biliary drainage in critically ill patients.
  • ENBD appears to be a preferable procedure, associated with lower mortality rates in this patient cohort.