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  1. Article ; Online: Performance of European and American Societies of Gastrointestinal Endoscopy Guidelines for Prediction of Choledocholithiasis in Patients with Acute Biliary Pancreatitis

    Žan Peter Černe / Nejc Sever / Luka Strniša / Samo Plut / Jan Drnovšek / Jurij Hanžel / Darko Siuka / Borut Štabuc / David Drobne

    Medicina, Vol 59, Iss 12, p

    2023  Volume 2176

    Abstract: Background and Objectives: Up to one-third of patients with acute biliary pancreatitis also present with choledocholithiasis. Guidelines from the European Society of Gastrointestinal Endoscopy (ESGE) and the American Society for Gastrointestinal ... ...

    Abstract Background and Objectives: Up to one-third of patients with acute biliary pancreatitis also present with choledocholithiasis. Guidelines from the European Society of Gastrointestinal Endoscopy (ESGE) and the American Society for Gastrointestinal Endoscopy (ASGE) for investigating suspected choledocholithiasis suggest endoscopic retrograde cholangiopancreatography in patients with high-likelihood (ESGE)/high-probability (ASGE) predictors and endoscopic ultrasound in those with intermediate-likelihood (ESGE)/intermediate-probability (ASGE) predictors. Although both guidelines are similar, they are not identical. Furthermore, these algorithms were mainly developed from cohorts of patients without pancreatitis and are therefore poorly validated in a subset of patients with acute pancreatitis. We aimed to assess the performance of the ESGE and ASGE algorithms for the prediction of choledocholithiasis in patients with acute biliary pancreatitis. Materials and Methods: This was a retrospective analysis of 86 consecutive patients admitted to a tertiary referral centre in the year 2020 due to acute biliary pancreatitis. Results: Choledocholithiasis was confirmed in 29/86 (33.7%) of patients (13 with endoscopic retrograde cholangiopancreatography and 16 with endoscopic ultrasound). All 10/10 (100%) ESGE high-likelihood and 14/19 (73.7%) ASGE high-probability patients had choledocholithiasis. Only 19/71 (26.8%) patients with ESGE intermediate likelihood and 15/67 (22.4%) with ASGE intermediate probability had choledocholithiasis. Only 8/13 (61.5%) patients with the ASGE high-probability predictor of dilated common bile duct plus bilirubin > 68.4 µmol/mL had choledocholithiasis. Since this predictor is not considered high likelihood by ESGE, this resulted in a superior specificity of the European compared to the American guideline (100% vs. 91.2%). Following the American instead of the European guidelines would have resulted in five unnecessary endoscopic retrograde cholangiopancreatographies and five unnecessary ...
    Keywords acute biliary pancreatitis ; endoscopic ultrasound ; ERCP ; choledocholithiasis ; ultrasound ; transabdominal ultrasound ; Medicine (General) ; R5-920
    Subject code 610
    Language English
    Publishing date 2023-12-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Comparable Triglyceride Reduction With Plasma Exchange and Insulin in Acute Pancreatitis – A Randomized Trial

    Jakob Gubensek / Milena Andonova / Alexander Jerman / Vanja Persic / Barbara Vajdic-Trampuz / Ana Zupunski-Cede / Nejc Sever / Samo Plut

    Frontiers in Medicine, Vol

    2022  Volume 9

    Abstract: Background and AimsBoth insulin and plasma exchange (PE) are used in hypertriglyceridemic acute pancreatitis (HTG-AP). Our aim was to compare the efficacy of both treatments.MethodsA randomized, parallel group study performed in a tertiary hospital in 22 ...

    Abstract Background and AimsBoth insulin and plasma exchange (PE) are used in hypertriglyceridemic acute pancreatitis (HTG-AP). Our aim was to compare the efficacy of both treatments.MethodsA randomized, parallel group study performed in a tertiary hospital in 22 HTG-AP patients with non-severe prognosis and triglycerides between 15 and 40 mmol/L. Patients were randomized to daily PE or insulin infusion until triglycerides were <10 mmol/L. Primary outcome was % reduction in triglycerides within 24 h. Secondary outcomes were days needed to lower triglycerides <10 mmol/L, highest CRP and percentage of patients with a severe course of pancreatitis.ResultsThere was a trend toward a greater decrease in triglycerides within the first 24 h in the PE group (67 ± 17% vs. 53 ± 17%, p = 0.07), but the absolute difference was modest [mean difference of 6 mmol/L (14% of initial value)]. Triglycerides fell below 10 mmol/L in a median (IQR) of 1 (1–2) and 2 (1–2) days, respectively (p = 0.25). Secondary outcomes related to disease severity were also comparable: highest CRP 229 vs. 211 mg/L (p = 0.69) and severe course of pancreatitis in 2/11 cases in both groups (p = 1.0). Regarding treatment complications, there was one mild hypoglycemia and one allergic reaction during PE. Survival was 100% in both groups.ConclusionThere was no significant difference, but only a trend toward a greater decrease in triglycerides with PE, and the clinical course was also comparable. These results do not support universal use of PE in patients with HTG-AP.Clinical Trial Registration[ClinicalTrials.gov], identifier [NCT02622854].
    Keywords acute hypertriglyceridemic pancreatitis ; hypertriglyceridemia ; apheresis – therapeutic ; conservative treatment ; free fatty acids ; Medicine (General) ; R5-920
    Subject code 610
    Language English
    Publishing date 2022-04-01T00:00:00Z
    Publisher Frontiers Media S.A.
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Collagenous gastritis

    Marija Malgaj / Nina Zidar / Nejc Sever

    Zdravniški Vestnik, Vol 85, Iss

    a case report

    2016  Volume 4

    Abstract: Background: Collagenous gastritis is a rare disease defined histologically by the subepithelial deposition of collagen bands thicker than 10 μm and the infiltration of inflammatory mononuclear cells in the lamina propria. There are approximately 60 ... ...

    Abstract Background: Collagenous gastritis is a rare disease defined histologically by the subepithelial deposition of collagen bands thicker than 10 μm and the infiltration of inflammatory mononuclear cells in the lamina propria. There are approximately 60 reported cases of collagenous gastritis in the English literature. Case report: We present a 41-year-old female patient with weight loss, postprandial abdominal discomfort, early satiety, flatulence and a change in bowel habits. Her current laboratory investigation reports showed mild sideropenic anemia. Esophagogastroduodenoscopy and corresponding histological examination showed findings, typical for collagenous gastritis. Gastric emptying scintigraphy and SPECT/CT of abdomen revealed gastroparesis. Conclusion: Collagenous gastritis is a diagnostically challenging disease and its exact etiology remains unclear. Even though collagenous gastritis is a histologic diagnosis, the combination of other key clinical and endoscopic findings should prompt consideration of this entity. No safe and effective treatment has been established. Therefore, better understanding of the disease and study of a larger number of patients will help to establish diagnostic criteria and therapeutic strategies.
    Keywords collagen deposition ; weight loss ; dyspepsia ; anemia ; nodular gastric mucosa ; Medicine ; R
    Subject code 610
    Language English
    Publishing date 2016-07-01T00:00:00Z
    Publisher Slovenian Medical Association
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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    Inter-library loan at ZB MED

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