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Efficacy and Safety of Pancreatobiliary Endoscopic Procedures during Pregnancy.

Lee JJ, Lee SK, Kim SH, Kim GH, Park do H, Lee S, Seo D, Kim MH - Gut Liver (2015)

Bottom Line: Only one patient had a complication, which was postprocedural hyperamylasemia.Two patients underwent an artificial abortion, one according to her own decision and the other due to an adverse drug reaction.ERCP seems to be effective and safe for pregnant women.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

ABSTRACT

Background/aims: Endoscopic therapy with endoscopic retrograde cholangiopancreatography (ERCP) has been suggested as an effective diagnostic and therapeutic tool for biliary and pancreatic disorders during pregnancy. In this report, we describe our experiences with pancreatobiliary endoscopic procedures during pregnancy.

Methods: We reviewed ERCP and endoscopic ultrasonography (EUS) procedures that were performed at a single tertiary care referral center between January 2002 and October 2013. Medical records were reviewed for the procedure indication, the duration of fluoroscopy, postprocedure complications, etc. Pregnancy outcomes and fetal complications were identified by chart review and phone calls to patients.

Results: A total of 10 ERCPs and five EUSs were performed in 13 pregnant patients four of whom underwent the procedure in the first trimester, eight in the second trimester, and one in the third trimester. Indications for endoscopic therapy included gallstone pancreatitis, obstructive jaundice with common bile duct (CBD) stone, asymptomatic CBD stone, pancreatic cyst, choledochal cyst, and acute cholecystitis. Only one patient had a complication, which was postprocedural hyperamylasemia. Two patients underwent an artificial abortion, one according to her own decision and the other due to an adverse drug reaction.

Conclusions: ERCP seems to be effective and safe for pregnant women. Additionally, EUS can be an alternative to ERCP during pregnancy.

No MeSH data available.


Related in: MedlinePlus

The pelvis of the patient was covered with a lead apron (case 4).
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f1-gnl-09-672: The pelvis of the patient was covered with a lead apron (case 4).

Mentions: We reviewed ERCP and EUS data from our endoscopy database which was performed in reproductive age (18 to 45 years) women between January 2002 and October 2013. ERCP and EUS were performed using Olympus TJF 260V (Olympus, Tokyo, Japan) and GF UCT 260 (Olympus) videoendoscope system, respectively. And digitalized fluoroscopy system (Hitachi TU-8000DR) was used to get images of biliary tree and pancreatic duct. In most cases, procedures were performed in the left lateral decubitus position to avoid compromise of venous return including one patient at the later stage of pregnancy. Endoscopic procedures were performed with conscious sedation by using midazolam occasionally and pethidine was given to all patients for pain control. Patients were monitored by pulse oximetry during the procedure. Prophylactic antibiotics such as cefotaxime or ceftizoxime were administered to those patients who have potential need for sphincterotomy or other therapeutic interventions. The pelvis of all patients who had notified of their pregnancy was lead-shielded to minimize radiation exposure to the fetus (Fig. 1).


Efficacy and Safety of Pancreatobiliary Endoscopic Procedures during Pregnancy.

Lee JJ, Lee SK, Kim SH, Kim GH, Park do H, Lee S, Seo D, Kim MH - Gut Liver (2015)

The pelvis of the patient was covered with a lead apron (case 4).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4562786&req=5

f1-gnl-09-672: The pelvis of the patient was covered with a lead apron (case 4).
Mentions: We reviewed ERCP and EUS data from our endoscopy database which was performed in reproductive age (18 to 45 years) women between January 2002 and October 2013. ERCP and EUS were performed using Olympus TJF 260V (Olympus, Tokyo, Japan) and GF UCT 260 (Olympus) videoendoscope system, respectively. And digitalized fluoroscopy system (Hitachi TU-8000DR) was used to get images of biliary tree and pancreatic duct. In most cases, procedures were performed in the left lateral decubitus position to avoid compromise of venous return including one patient at the later stage of pregnancy. Endoscopic procedures were performed with conscious sedation by using midazolam occasionally and pethidine was given to all patients for pain control. Patients were monitored by pulse oximetry during the procedure. Prophylactic antibiotics such as cefotaxime or ceftizoxime were administered to those patients who have potential need for sphincterotomy or other therapeutic interventions. The pelvis of all patients who had notified of their pregnancy was lead-shielded to minimize radiation exposure to the fetus (Fig. 1).

Bottom Line: Only one patient had a complication, which was postprocedural hyperamylasemia.Two patients underwent an artificial abortion, one according to her own decision and the other due to an adverse drug reaction.ERCP seems to be effective and safe for pregnant women.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

ABSTRACT

Background/aims: Endoscopic therapy with endoscopic retrograde cholangiopancreatography (ERCP) has been suggested as an effective diagnostic and therapeutic tool for biliary and pancreatic disorders during pregnancy. In this report, we describe our experiences with pancreatobiliary endoscopic procedures during pregnancy.

Methods: We reviewed ERCP and endoscopic ultrasonography (EUS) procedures that were performed at a single tertiary care referral center between January 2002 and October 2013. Medical records were reviewed for the procedure indication, the duration of fluoroscopy, postprocedure complications, etc. Pregnancy outcomes and fetal complications were identified by chart review and phone calls to patients.

Results: A total of 10 ERCPs and five EUSs were performed in 13 pregnant patients four of whom underwent the procedure in the first trimester, eight in the second trimester, and one in the third trimester. Indications for endoscopic therapy included gallstone pancreatitis, obstructive jaundice with common bile duct (CBD) stone, asymptomatic CBD stone, pancreatic cyst, choledochal cyst, and acute cholecystitis. Only one patient had a complication, which was postprocedural hyperamylasemia. Two patients underwent an artificial abortion, one according to her own decision and the other due to an adverse drug reaction.

Conclusions: ERCP seems to be effective and safe for pregnant women. Additionally, EUS can be an alternative to ERCP during pregnancy.

No MeSH data available.


Related in: MedlinePlus