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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

A patient who underwent infundibulotomy developed hyperamylasemia (case 6).
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getmorefigures.php?uid=PMC4562786&req=5

f3-gnl-09-672: A patient who underwent infundibulotomy developed hyperamylasemia (case 6).

Mentions: Complications occurred in two patients who had infundibulotomy and EUS-guided procedure respectively (Table 1). The patient who had infundibulotomy developed hyperaylasemia which responded well to conservative treatment (case 6). We did not take radiographs to lessen the fluoroscopy time and used a technique of bile aspiration to confirm selective bile duct cannulation (Fig. 3). And the other patient developed pulmonary edema (case 11). It was assumed that the pulmonary edema was related with ritodrine side effect and not with any procedures. When she arrived at our medical center, gynecologists administered a ritodrine to prevent preterm delivery as her cervical dilatation was proceeding. And we immediately performed EUS-guided procedure for decompression of GB. She complained of dyspnea after the procedure, so chest X-ray was done and we found out that pulmonary edema had occurred (Fig. 4). Based on our discussion with gynecologists, we concluded that termination of pregnancy was needed to resolve pulmonary edema. Under the agreement of both the patient and her spouse, artificial abortion procedure was performed and she recovered from pulmonary edema.


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)

A patient who underwent infundibulotomy developed hyperamylasemia (case 6).
© Copyright Policy
Related In: Results  -  Collection

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

f3-gnl-09-672: A patient who underwent infundibulotomy developed hyperamylasemia (case 6).
Mentions: Complications occurred in two patients who had infundibulotomy and EUS-guided procedure respectively (Table 1). The patient who had infundibulotomy developed hyperaylasemia which responded well to conservative treatment (case 6). We did not take radiographs to lessen the fluoroscopy time and used a technique of bile aspiration to confirm selective bile duct cannulation (Fig. 3). And the other patient developed pulmonary edema (case 11). It was assumed that the pulmonary edema was related with ritodrine side effect and not with any procedures. When she arrived at our medical center, gynecologists administered a ritodrine to prevent preterm delivery as her cervical dilatation was proceeding. And we immediately performed EUS-guided procedure for decompression of GB. She complained of dyspnea after the procedure, so chest X-ray was done and we found out that pulmonary edema had occurred (Fig. 4). Based on our discussion with gynecologists, we concluded that termination of pregnancy was needed to resolve pulmonary edema. Under the agreement of both the patient and her spouse, artificial abortion procedure was performed and she recovered from pulmonary edema.

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