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RISS 인기검색어
- 검색키워드
- 저자 : Lalitha M. Sitaraman (검색결과 2 건)
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Lalitha M. Sitaraman,Rita M. Knotts,Judith Kim,Srihari Mahadev,David S. Lee 대한소화기내시경학회 2021 Clinical Endoscopy Vol.54 No.1
Background/Aims: To determine if patients with a positive intraoperative cholangiogram (IOC) who undergo a subsequentendoscopic retrograde cholangiopancreatography (ERCP) have an increased risk of post-ERCP pancreatitis (PEP) compared to thosewho undergo ERCP directly for suspected common bile duct stones. Methods: A retrospective case-control study was performed from 2010 to 2016. Cases included inpatients with a positive IOC atcholecystectomy who underwent subsequent ERCP. The control group included age-sex matched cohorts who underwent ERCP forcholedocholithiasis. Multivariate logistic regression was used to assess the association between PEP and positive IOC, adjusting formatching variables and additional potential confounders. Results: Of the 116 patients that met the inclusion criteria, there were 91 women (78%) in each group. Nine patients (7.8%)developed PEP in the IOC group, compared to 3 patients in the control group (2.6%). The use of pancreatic duct stents and rectalindomethacin was similar in both groups. After adjusting for age, sex, total bilirubin levels, and any stent placement, patients with apositive IOC had a significantly increased risk of PEP (odds ratio, 4.79; 95% confidence interval, 1.05–21.89; p<0.05). Conclusions: In this single-center case-control study, there was a five-fold increased risk of PEP following a positive IOC comparedto an age-sex matched cohort.
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Lalitha M. Sitaraman,Amit H. Sachdev,Tamas A. Gonda,Amrita Sethi,John M. Poneros,Frank G. Gress 대한소화기내시경학회 2019 Clinical Endoscopy Vol.52 No.2
Background/Aims: The aim of this study was to describe the diagnostic yield of endoscopic ultrasound (EUS) in patients with isolatedelevated levels of amylase and/or lipase. Methods: A retrospective chart review was conducted at a large academic medical center from 2000 to 2016. Patients were selectedbased on having elevated amylase, lipase, or both, but without a diagnosis of pancreatitis or known pancreatobiliary disease. Patientswere excluded if they had abnormal liver function tests or abnormal imaging of the pancreas. Results: Of 299 EUS procedures performed, 38 met inclusion criteria. Symptoms were present in 31 patients, most frequentlyabdominal pain (87%). In 20 patients (53%), initial EUS most commonly found chronic pancreatitis (n=7; 18%), sludge (5; 13%), or newdiagnosis of pancreas divisum (3; 8%). In the asymptomatic patients (7), 3 had a finding on EUS, most importantly sludge (2), stone (1),and pancreas divisum (1). No patients were diagnosed with a mass or pancreatic cyst. During the follow up period, 6 patients (22%) hadcholecystectomy. Conclusions: In our study of patients with isolated elevations in amylase and/or lipase without acute pancreatitis who underwent EUS,approximately 50% had a pancreatobiliary finding, most commonly chronic pancreatitis or biliary sludge.
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