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  1. Article: Management of Acute Pancreatitis in the Early Stage.

    Zarnescu, Narcis Octavian / Barbu, Sorin Traian / Zarnescu Vasiliu, Eugenia Claudia / Costea, Radu / Neagu, Stefan

    Maedica

    2017  Volume 10, Issue 3, Page(s) 257–263

    Abstract: Acute pancreatitis (AP) is a potential fatal disease with an overall mortality around 5 ... the impact of early phase treatment is presented in terms of benefits and risks. ... the fluid therapy, pain management, antibiotic prophylaxis, apheresis for hypertriglyceridemia-induced AP, timing ...

    Abstract Acute pancreatitis (AP) is a potential fatal disease with an overall mortality around 5%. The current treatment for AP relies on supportive medical therapy, sometimes associated with endoscopic procedures and/or surgical interventions. In this review we discuss the recent concepts regarding the fluid therapy, pain management, antibiotic prophylaxis, apheresis for hypertriglyceridemia-induced AP, timing and indications for ERCP and cholecystectomy in biliary AP. For each component, the importance and the impact of early phase treatment is presented in terms of benefits and risks.
    Language English
    Publishing date 2017-02-11
    Publishing country Romania
    Document type Journal Article
    ZDB-ID 2399972-X
    ISSN 2069-6116 ; 1841-9038
    ISSN (online) 2069-6116
    ISSN 1841-9038
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  2. Article ; Online: Management of Acute Liver Failure: Update 2022.

    Tujios, Shannan / Stravitz, R Todd / Lee, William M

    Seminars in liver disease

    2022  Volume 42, Issue 3, Page(s) 362–378

    Abstract: ... outcomes over the past two decades. Optimal management begins with identifying that liver failure is indeed ... hepatocellular contents into the circulation with multiorgan effects/consequences.Management involves optimizing ... Abbreviated pathogenesis and clinical course of the acute liver failure syndrome. The pathogenesis ...

    Abstract Abbreviated pathogenesis and clinical course of the acute liver failure syndrome. The pathogenesis and clinical course of the syndrome of acute liver failure (ALF) differs depending upon the etiology of the primary liver injury. In turn, the severity of the liver injury and resulting synthetic failure is often the primary determinant of whether a patient is referred for emergency liver transplantation. Injuries by viral etiologies trigger the innate immune system via pathogen-associated molecular patterns (PAMPs), while toxin-induced (and presumably ischemia-induced) injuries do so via damage-associated molecular patterns (DAMPs). The course of the clinical syndrome further depends upon the relative intensity and composition of cytokine release, resulting in an early proinflammatory phenotype (SIRS) and later compensatory anti-inflammatory response phenotype (CARS). The outcomes of overwhelming immune activation are the systemic (extrahepatic) features of ALF (cardiovascular collapse, cerebral edema, acute kidney injury, respiratory failure, sepsis) which ultimately determine the likelihood of death.Acute liver failure (ALF) continues to carry a high risk of mortality or the need for transplantation despite recent improvements in overall outcomes over the past two decades. Optimal management begins with identifying that liver failure is indeed present and its etiology, since outcomes and the need for transplantation vary widely across the different etiologies. Most causes of ALF can be divided into hyperacute (ischemia and acetaminophen) and subacute types (other etiologies), based on time of evolution of signs and symptoms of liver failure; the former evolve in 3 to 4 days and the latter typically in 2 to 4 weeks. Both involve intense release of cytokines and hepatocellular contents into the circulation with multiorgan effects/consequences.Management involves optimizing fluid balance and cardiovascular support, including the use of continuous renal replacement therapy, vasopressors, and pulmonary ventilation. Early evaluation for liver transplantation is advised particularly for acetaminophen toxicity, which evolves so rapidly that delay is likely to lead to death.Vasopressor support, high-grade hepatic encephalopathy, and unfavorable (subacute) etiologies heighten the need for urgent listing for liver transplantation. Prognostic scores such as Kings Criteria, Model for End-Stage Liver Disease, and the Acute Liver Failure Group prognostic index take these features into account and provide reasonable but imperfect predictive accuracy. Future treatments may include liver support devices and/or agents that improve hepatocyte regeneration.
    MeSH term(s) Acetaminophen/adverse effects ; End Stage Liver Disease/complications ; Humans ; Liver Failure, Acute/diagnosis ; Liver Failure, Acute/etiology ; Liver Failure, Acute/therapy ; Liver Transplantation/adverse effects ; Severity of Illness Index
    Chemical Substances Acetaminophen (362O9ITL9D)
    Language English
    Publishing date 2022-08-24
    Publishing country United States
    Document type Journal Article
    ZDB-ID 603177-8
    ISSN 1098-8971 ; 0272-8087
    ISSN (online) 1098-8971
    ISSN 0272-8087
    DOI 10.1055/s-0042-1755274
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  3. Article ; Online: Acute-on-chronic liver failure: Terminology, mechanisms and management.

    Br, Vinay Kumar / Sarin, Shiv Kumar

    Clinical and molecular hepatology

    2023  Volume 29, Issue 3, Page(s) 670–689

    Abstract: ... of acute insult. Patients should be considered for early transplant with MELD score >28, AARC score >10 ... score, a model for end stage liver disease (MELD), and the CLIF Consortium acute ... Acute-on-chronic liver failure is an acute deterioration of liver function manifesting as jaundice ...

    Abstract Acute-on-chronic liver failure is an acute deterioration of liver function manifesting as jaundice and coagulopathy with the development of ascites, with a high probability of extrahepatic organ involvement and high 28-day mortality. The pathogenesis involves extensive hepatic necrosis, which is associated with severe systemic inflammation and subsequently causes the cytokine storm, leading to portal hypertension, organ dysfunction, and organ failure. These patients have increased gut permeability, releasing lipopolysaccharide (LPS) and damage-associated molecular patterns (DAMPS) in the blood, leading to hyper-immune activation and the secretion of cytokines, followed by immune paralysis, causing the development of infections and organ failure in a proportion of patients. Early detection and the institution of treatment, especially in the "Golden Window" period of 7 days, gives an opportunity for reversal of the syndrome. Scores like the Asian Pacific Association for the Study of the Liver (APASL) ACLF research consortium (AARC) score, a model for end stage liver disease (MELD), and the CLIF Consortium acute-on-chronic liver failure (CLIF-C ACLF) score can help in the prediction of mortality. Treatment strategy includes treatment of acute insult. Patients should be considered for early transplant with MELD score >28, AARC score >10, high-grade hepatic encephalopathy, and in the absence of >2 organ failure or overt sepsis to improve survival of up to 80% at five years. Patients, with no option of transplant, can be treated with emerging therapies like faecal microbial transplant, plasma exchange, etc., which need further evaluation.
    MeSH term(s) Humans ; Severity of Illness Index ; Acute-On-Chronic Liver Failure/diagnosis ; Acute-On-Chronic Liver Failure/therapy ; Acute-On-Chronic Liver Failure/etiology ; End Stage Liver Disease ; Prognosis ; Hepatic Encephalopathy/complications
    Language English
    Publishing date 2023-03-20
    Publishing country Korea (South)
    Document type Journal Article ; Review
    ZDB-ID 2672560-5
    ISSN 2287-285X ; 2287-2728
    ISSN (online) 2287-285X
    ISSN 2287-2728
    DOI 10.3350/cmh.2022.0103
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  4. Article ; Online: What has changed? The impact of the COVID-19 pandemic on the management of acute biliary pancreatitis.

    Türkyılmaz, Zeliha / Demirel, Tugrul / Cakcak, İbrahim Ethem / Aytin, Yusuf Emre

    Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES

    2023  Volume 29, Issue 10, Page(s) 1167–1174

    Abstract: ... We retrospectively evaluated the impact of the COVID-19 pandemic on our management strategies for patients with acute ... patients in the early stages of the disease to hospitals, leading to inevitable admissions in advanced ... biliary pancreatitis (ABP).: Methods: A total of 91 patients with ABP who were treated at Trakya ...

    Title translation Ne değişti? COVID-19 pandemisinin akut biliyer pankreatit tedavisine etkisi.
    Abstract Background: The COVID-19 pandemic thoroughly changed the daily practices of medicine. We retrospectively evaluated the impact of the COVID-19 pandemic on our management strategies for patients with acute biliary pancreatitis (ABP).
    Methods: A total of 91 patients with ABP who were treated at Trakya University Faculty of Medicine between March 15, 2019 and March 15, 2021 were retrospectively recruited. Patients were classified as pre-COVID and COVID-era patients. The comorbidity markers, data from laboratory tests, inflammatory markers, and radiological examinations were evaluated. Length of stay, need for an intensive care unit, morbidity, mortality, recurrent ABP, and definitive treatment rates were evaluated, and the data of the two periods were compared.
    Results: Two groups of patients, 57 in the pre-COVID period and 34 in the COVID period, were included in the study. We found that ABP admissions decreased significantly during periods of increased national COVID-19 diagnoses. Type 2 diabetes mellitus was significantly higher in the COVID period patients (P=0.044), and COVID patients had significantly higher total (P=0.004), direct bili-rubin (P=0.007), and lipases (P<0.001). The cholecystectomy rate after an attack decreased from 26% in the pre-COVID period to 15.6% during COVID.
    Conclusion: COVID strikingly reduced the admissions of ABP patients in the early stages of the disease to hospitals, leading to inevitable admissions in advanced severity. Moreover, a significant increase was detected in the recurrence rates of ABP. This can be explained by the reduction in cholecystectomy performed.
    MeSH term(s) Humans ; Retrospective Studies ; Cholangiopancreatography, Endoscopic Retrograde ; Diabetes Mellitus, Type 2 ; Pandemics ; COVID-19/epidemiology ; Pancreatitis/diagnosis ; Acute Disease
    Language English
    Publishing date 2023-09-23
    Publishing country Turkey
    Document type Journal Article
    ZDB-ID 2253739-9
    ISSN 1307-7945 ; 1306-696X
    ISSN (online) 1307-7945
    ISSN 1306-696X
    DOI 10.14744/tjtes.2023.06486
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  5. Article: Optic Neuritis in Resolving Phase of COVID-19 Infection and Its Management: A Case Report.

    Singh, Aanchal / Mathurkar, Swapneel

    Cureus

    2024  Volume 16, Issue 4, Page(s) e58257

    Abstract: ... in the resolving stage of COVID-19 infection. Early detection and treatment with steroids can result in the best ... disease 2019 (COVID-19) and optic neuritis and to study the management of optic neuritis in the resolving ... to support the above treatment plan for optic neuritis caused by the severe acute ...

    Abstract Optic neuritis is assumed to be immune-mediated, although the specific antigens that cause demyelination are uncertain. Systemic T-cell activation is detected at the onset of symptoms, which occurs before alterations in cerebrospinal fluid (CSF). The optic nerve disease is a rare disease and can occur in one or both eyes, especially in those with no established inflammatory or autoimmune illnesses. Adult ophthalmic neuritis is usually unilateral and is frequently associated with multiple sclerosis (MS). Generally, it starts as a rapid loss of vision and pain in eye movement. It progresses and achieves the maximal deficiency over a week. The objectives of this paper were to determine the association between coronavirus disease 2019 (COVID-19) and optic neuritis and to study the management of optic neuritis in the resolving phase of COVID-19. A case study was done on a 38-year-old female complaining of sudden diminution of vision in her right eye for one week. She tested positive on the reverse transcriptase-polymerase chain reaction (RT-PCR) test for COVID-19 for which she was managed symptomatically and was started on antiretrovirals. This case report is based on an infrequent COVID-19 complication. It has been proposed that this virus has the probability of manifesting various neurological complications. In our case, optic neuritis occurs mainly three weeks after COVID-19 infection. Our patient was managed by intravenous methylprednisolone injection followed by oral prednisone for 14 days. So, further case studies will be required to support the above treatment plan for optic neuritis caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Unilateral or bilateral optic neuritis can occur as a neurological complication in the resolving stage of COVID-19 infection. Early detection and treatment with steroids can result in the best visual outcome.
    Language English
    Publishing date 2024-04-14
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.58257
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  6. Article ; Online: Ascites in Acute Pancreatitis: Clinical Implications and Management.

    Bush, Nikhil / Rana, Surinder Singh

    Digestive diseases and sciences

    2021  Volume 67, Issue 6, Page(s) 1987–1993

    Abstract: Clinically significant ascites in acute pancreatitis (AP) is rarely encountered and is a result ... of multifactorial pathogenesis. Early reactionary ascites in AP usually does not require any treatment and resolves ... with amylase > 1000 U/l is highly suggestive of pancreatic ascites that is usually associated with duct ...

    Abstract Clinically significant ascites in acute pancreatitis (AP) is rarely encountered and is a result of multifactorial pathogenesis. Early reactionary ascites in AP usually does not require any treatment and resolves spontaneously in majority of patients. A diagnostic analysis should be performed in case of ascites developing in the latter stages with increasing pain or worsening organ failure. Low serum albumin-ascites gradient ascites with amylase > 1000 U/l is highly suggestive of pancreatic ascites that is usually associated with duct disruption. A combination of nasojejunal feeding, subcutaneous octreotide, endoscopic drainage and rarely, surgery are employed in managing this difficult to treat condition. There is a need of further studies to better understand the clinical role of ascites as well as contribution of other factors like hypoalbuminemia and portal hypertension to its development in AP.
    MeSH term(s) Acute Disease ; Amylases ; Ascites/diagnosis ; Ascites/etiology ; Ascites/therapy ; Humans ; Pancreatic Diseases/diagnosis ; Pancreatitis/complications ; Pancreatitis/diagnosis
    Chemical Substances Amylases (EC 3.2.1.-)
    Language English
    Publishing date 2021-05-25
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 304250-9
    ISSN 1573-2568 ; 0163-2116
    ISSN (online) 1573-2568
    ISSN 0163-2116
    DOI 10.1007/s10620-021-07063-6
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  7. Article: Vogt-Koyanagi-Harada Disease: The Clinical Spectrum and Management of Case Series in a Tertiary Eye Centre in Northern Part Of Malaysia.

    Hasan, Atiqah Nur / Mustapha, Mushawiahti / Wan, Haslina Abdul Halim Wan

    Ceska a slovenska oftalmologie : casopis Ceske oftalmologicke spolecnosti a Slovenske oftalmologicke spolecnosti

    2024  Volume 80, Issue Ahead of print, Page(s) 1–5

    Abstract: ... of the disease in the acute stage. Most of our patients achieved good visual outcomes with early immunomodulatory treatment ... with female predominance (85.7%). All cases presented with acute uveitic stage and bilateral eye involvement ... Aims: We present the clinical spectrum, the initial clinical presentation with management trends ...

    Title translation VOGT-KOYANAGI-HARADA DISEASE: THE CLINICAL SPECTRUM AND MANAGEMENT OF CASE SERIES IN A TERTIARY EYE CENTRE IN NORTHERN PART OF MALAYSIA.
    Abstract Aims: We present the clinical spectrum, the initial clinical presentation with management trends in treating 14 Vogt-Koyanagi-Harada (VKH) disease cases in a tertiary center in the Northern part of Malaysia.
    Case series: There were 14 cases of Vogt-Koyanagi-Harada (VKH) disease retrospectively reviewed over five years (from 2015 to 2020). The mean age at presentation was 37.7 years (range 21-64 years), with female predominance (85.7%). All cases presented with acute uveitic stage and bilateral eye involvement. Of them, 11 (78.6%) were probable VKH, and three (21.4%) were incomplete VKH. All patients attended with acute panuveitis at first presentation. The main posterior segment involvement was disc edema in 57.1% (16 out of 28 eyes) and exudative retinal detachment (ERD) in 35.7% (10 out of 28 eyes). Most of them presented with blindness (3/60 and worse) and moderate visual impair- ment (6/18-6/60); 35.71% each, followed by mild visual impairment (6/12-6/18), and severe visual impairment (6/60-3/60); 7.1% each. Ten patients (71.4%) required combination second-line immunomodulatory treatment during subsequent visits, and only four patients (28.6%) responded well to corticosteroid therapy. Most of the cases achieved no visual impairment (64.3%), followed by mild visual impairment (21.4%) and moderate visual impairment (14.3%), and none were severe or blind at the end of follow-up.
    Conclusion: VKH is a potentially blinding illness if there is inadequate control of the disease in the acute stage. Most of our patients achieved good visual outcomes with early immunomodulatory treatment and systemic corticosteroids.
    MeSH term(s) Humans ; Female ; Young Adult ; Adult ; Middle Aged ; Male ; Uveomeningoencephalitic Syndrome/diagnosis ; Uveomeningoencephalitic Syndrome/drug therapy ; Retrospective Studies ; Malaysia/epidemiology ; Glucocorticoids ; Vision Disorders ; Blindness/drug therapy
    Chemical Substances Glucocorticoids
    Language English
    Publishing date 2024-02-27
    Publishing country Czech Republic
    Document type Journal Article
    ZDB-ID 1235298-6
    ISSN 1805-4447 ; 1211-9059 ; 0009-059X
    ISSN (online) 1805-4447
    ISSN 1211-9059 ; 0009-059X
    DOI 10.31348/2024/1
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  8. Article ; Online: Updated strategies in the management of acute variceal haemorrhage.

    Edelson, Jerome / Basso, Jessica E / Rockey, Don C

    Current opinion in gastroenterology

    2021  Volume 37, Issue 3, Page(s) 167–172

    Abstract: ... confirmed the role of early transjugular intrahepatic portosystemic shunt (TIPS) in the management of acute ... Purpose of review: This article reviews the most recent studies regarding the management of acute ... of the management of variceal bleeding remain poorly studied such as the role of early TIPS in Child-B patients ...

    Abstract Purpose of review: This article reviews the most recent studies regarding the management of acute esophageal variceal haemorrhage.
    Recent findings: New randomized control trials and meta-analyses confirmed the role of early transjugular intrahepatic portosystemic shunt (TIPS) in the management of acute variceal haemorrhage in Child-Pugh C (10-13) and B patients with active bleeding. A recent randomized controlled trial focused on the duration of vasoactive therapy showed no difference between 2 and 5 days of octreotide. A randomized trial showed decreased use of blood products for the correction of coagulopathy using a thromboelastography-guided approach (vs. conventional parameters) as well as decreased bleeding rates when compared with standard of care. A meta-analysis found that for rescue of variceal bleeding, self-expanding metallic stents were more efficacious and safer than balloon tamponade. In addition, studies showed that Child-Pugh C patients and those with hepatic vein pressure gradient more than 20 were at the highest risk of treatment failure, while model for end-stage liver disease was highly predictive of in-hospital mortality.
    Summary: In patients with severe coagulopathy and uncontrolled bleeding, TEG-based transfusion strategies are recommended. Antibiotics should be used for all cirrhotic patients presenting with upper gastrointestinal bleeding, but should be tailored in accordance to local resistance patterns. Early TIPS for high-risk patients has been shown to have a significant survival benefit. Certain aspects of the management of variceal bleeding remain poorly studied such as the role of early TIPS in Child-B patients as well as strategies for rescue therapy in patients who are not TIPS candidates, and require further investigation.
    MeSH term(s) End Stage Liver Disease ; Esophageal and Gastric Varices/etiology ; Esophageal and Gastric Varices/therapy ; Gastrointestinal Hemorrhage/etiology ; Gastrointestinal Hemorrhage/therapy ; Humans ; Liver Cirrhosis ; Portasystemic Shunt, Transjugular Intrahepatic ; Severity of Illness Index
    Language English
    Publishing date 2021-03-25
    Publishing country United States
    Document type Journal Article ; Meta-Analysis ; Research Support, N.I.H., Extramural ; Review
    ZDB-ID 632571-3
    ISSN 1531-7056 ; 0267-1379
    ISSN (online) 1531-7056
    ISSN 0267-1379
    DOI 10.1097/MOG.0000000000000723
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  9. Article ; Online: Management of biliary acute pancreatitis.

    Bougard, M / Barbier, L / Godart, B / Le Bayon-Bréard, A-G / Marques, F / Salamé, E

    Journal of visceral surgery

    2018  Volume 156, Issue 2, Page(s) 113–125

    Abstract: ... to clinical and biological evolution. Management of acute biliary pancreatitis varies according ... feeding. For moderately severe and severe acute pancreatitis, treatment is based on resuscitation, early ... Acute pancreatitis is a frequent pathology with 11,000 to 13,000 new cases per year in France ...

    Abstract Acute pancreatitis is a frequent pathology with 11,000 to 13,000 new cases per year in France. A biliary origin (30 to 70% of the cases) should be suspected when alanine amino-transferases are elevated during the first 48 hours, and it is confirmed by the presence of gallstones at trans abdominal ultrasound. Abdominal computed-tomography scan is performed around the fifth day, and is repeated according to clinical and biological evolution. Management of acute biliary pancreatitis varies according to its severity, which should be assessed according to systemic inflammatory response syndrome and organ failures. For mild acute pancreatitis, cholecystectomy should be performed during in-hospital stay, before oral feeding. For moderately severe and severe acute pancreatitis, treatment is based on resuscitation, early enteral continuous feeding, and management of complications. Interval cholecystectomy is performed at a later stage. Endoscopic retrograde cholangiopancreatography with sphincterotomy should be performed in emergency when angiocholitis is associated, and in delayed emergency before oral feeding for persistent common bile duct stone. A common bile duct stone should be searched for during cholecystectomy and can be treated during the same surgical procedure if local conditions are adequate. Cholelithiasis is the most frequent cause of acute pancreatitis during pregnancy, and its diagnosis and the treatment have some particularities.
    MeSH term(s) Alanine Transaminase/blood ; Biomarkers/blood ; Cholangiopancreatography, Endoscopic Retrograde/methods ; Choledocholithiasis/complications ; Choledocholithiasis/diagnostic imaging ; Cholelithiasis/complications ; Cholelithiasis/diagnostic imaging ; Drainage ; Enteral Nutrition ; Female ; Gallstones/complications ; Gallstones/diagnostic imaging ; Humans ; Intra-Abdominal Hypertension/diagnosis ; Length of Stay ; Multiple Organ Failure/diagnosis ; Pancreatic Pseudocyst/diagnosis ; Pancreatic Pseudocyst/etiology ; Pancreatic Pseudocyst/therapy ; Pancreatitis/diagnosis ; Pancreatitis/etiology ; Pancreatitis/therapy ; Pancreatitis, Acute Necrotizing/therapy ; Pregnancy ; Pregnancy Complications/diagnosis ; Severity of Illness Index ; Systemic Inflammatory Response Syndrome/diagnosis ; Tomography, X-Ray Computed ; Ultrasonography ; Vascular Diseases/etiology
    Chemical Substances Biomarkers ; Alanine Transaminase (EC 2.6.1.2)
    Language English
    Publishing date 2018-10-30
    Publishing country France
    Document type Journal Article ; Review
    ISSN 1878-7886
    ISSN (online) 1878-7886
    DOI 10.1016/j.jviscsurg.2018.08.002
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  10. Article ; Online: One-stage versus two-stage endoscopic management for acute cholangitis caused by common bile duct stones: A retrospective multicenter cohort study.

    Maruta, Akinori / Iwashita, Takuji / Yoshida, Kensaku / Iwasa, Yuhei / Okuno, Mitsuru / Iwata, Keisuke / Tezuka, Ryuichi / Uemura, Shinya / Shimizu, Shogo / Shimizu, Masahito

    Journal of hepato-biliary-pancreatic sciences

    2024  

    Abstract: ... study was to compare the short- and long-term outcomes between one- and two-stage management for acute ... stage endoscopic management for acute cholangitis between May 2010 and December 2020. The patients were ... difference in the early adverse event (AE) between two groups, post-ERCP pancreatitis was recognized in 3.4 ...

    Abstract Background: One-stage endoscopic management, where papillary interventions and stone removal are simultaneously performed, has been reported to be an effective treatment for acute cholangitis caused by common bile duct stones (CBDS). However, there have been few reports comparing it with two-stage management, and there is no established strategy for the indication of one-stage management. The aim of the present study was to compare the short- and long-term outcomes between one- and two-stage management for acute cholangitis caused by CBDS.
    Methods: We retrospectively studied 577 patients who underwent one- or two-stage endoscopic management for acute cholangitis between May 2010 and December 2020. The patients were divided into one- and two-stage groups by endoscopic management. The clinical outcomes were compared between groups.
    Results: The technical and clinical success were similar in both groups, although the length of hospital stay was significantly shorter in the one-stage group. Although there was no difference in the early adverse event (AE) between two groups, post-ERCP pancreatitis was recognized in 3.4% and 10.0%, which was significantly higher in the two-stage group. The cumulative late AE rate was 22.6% and 14.1%, which was significantly higher in the one-stage group. In the multivariate analyses, intervention (one-stage), number of CBDS ≥2, biliary drainage, the use of ML, and gallbladder stone were identified as significant factors associated with the recurrence of CBDS.
    Conclusion: Although one-stage endoscopic management is useful and safe with reducing hospital stays, diligent postoperative follow-up with consideration to recurrence of CBDS is essential.
    Language English
    Publishing date 2024-03-18
    Publishing country Japan
    Document type Journal Article
    ZDB-ID 2536236-7
    ISSN 1868-6982 ; 1868-6974
    ISSN (online) 1868-6982
    ISSN 1868-6974
    DOI 10.1002/jhbp.1431
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