Practice Patterns and Use of Endoscopic Retrograde Cholangiopancreatography in the Management of Recurrent Acute Pancreatitis
Background/Aims There are conflicting opinions regarding the management of recurrent acute pancreatitis (RAP). While some physicians recommend endoscopic retrograde cholangiopancreatography (ERCP) in this setting, others consider it to be contraindicated in patients with RAP. The aim of this study w...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Korean Society of Gastrointestinal Endoscopy
2020-01-01
|
| Series: | Clinical Endoscopy |
| Subjects: | |
| Online Access: | http://www.e-ce.org/upload/pdf/ce-2019-052.pdf |
| _version_ | 1827802622658084864 |
|---|---|
| author | Jonathan B. Reichstein Vaishali Patel Parit Mekaroonkamol Sunil Dacha Steven A. Keilin Qiang Cai Field F. Willingham |
| author_facet | Jonathan B. Reichstein Vaishali Patel Parit Mekaroonkamol Sunil Dacha Steven A. Keilin Qiang Cai Field F. Willingham |
| author_sort | Jonathan B. Reichstein |
| collection | DOAJ |
| description | Background/Aims There are conflicting opinions regarding the management of recurrent acute pancreatitis (RAP). While some physicians recommend endoscopic retrograde cholangiopancreatography (ERCP) in this setting, others consider it to be contraindicated in patients with RAP. The aim of this study was to assess the practice patterns and clinical features influencing the management of RAP in the US. Methods An anonymous 35-question survey instrument was developed and refined through multiple iterations, and its use was approved by our Institutional Review Board. The survey was distributed via email to 408 gastroenterologists to assess the practice patterns in the management of RAP in multiple clinical scenarios. Results The survey was completed by 65 participants representing 36 of the top academic/tertiary care centers across the country. Approximately 90.8% of the participants indicated that they might offer or recommend ERCP in the management of RAP. Multinomial logistic regression analysis revealed that ductal dilatation and presence of symptoms were the most predictive variables (p<0.001) for offering ERCP. Conclusions A preponderance of the respondents would consider ERCP among patients with RAP presenting to tertiary care centers in the US. Ductal dilatation, presence of symptoms, and pancreas divisum significantly increased the likelihood of a recommendation for ERCP. |
| first_indexed | 2024-03-11T20:42:38Z |
| format | Article |
| id | doaj.art-ada21e4b3be84500affb24270a9cfb48 |
| institution | Directory Open Access Journal |
| issn | 2234-2400 2234-2443 |
| language | English |
| last_indexed | 2024-03-11T20:42:38Z |
| publishDate | 2020-01-01 |
| publisher | Korean Society of Gastrointestinal Endoscopy |
| record_format | Article |
| series | Clinical Endoscopy |
| spelling | doaj.art-ada21e4b3be84500affb24270a9cfb482023-10-02T01:16:04ZengKorean Society of Gastrointestinal EndoscopyClinical Endoscopy2234-24002234-24432020-01-01531738110.5946/ce.2019.0527231Practice Patterns and Use of Endoscopic Retrograde Cholangiopancreatography in the Management of Recurrent Acute PancreatitisJonathan B. Reichstein0Vaishali Patel1Parit Mekaroonkamol2Sunil Dacha3Steven A. Keilin4Qiang Cai5Field F. Willingham6 Department of Medicine, Duke University, Durham, NC, USA Division of Digestive Disease, Department of Medicine, Emory University, Atlanta, GA, USA Division of Digestive Disease, Department of Medicine, Emory University, Atlanta, GA, USA Division of Digestive Disease, Department of Medicine, Emory University, Atlanta, GA, USA Division of Digestive Disease, Department of Medicine, Emory University, Atlanta, GA, USA Division of Digestive Disease, Department of Medicine, Emory University, Atlanta, GA, USA Division of Digestive Disease, Department of Medicine, Emory University, Atlanta, GA, USABackground/Aims There are conflicting opinions regarding the management of recurrent acute pancreatitis (RAP). While some physicians recommend endoscopic retrograde cholangiopancreatography (ERCP) in this setting, others consider it to be contraindicated in patients with RAP. The aim of this study was to assess the practice patterns and clinical features influencing the management of RAP in the US. Methods An anonymous 35-question survey instrument was developed and refined through multiple iterations, and its use was approved by our Institutional Review Board. The survey was distributed via email to 408 gastroenterologists to assess the practice patterns in the management of RAP in multiple clinical scenarios. Results The survey was completed by 65 participants representing 36 of the top academic/tertiary care centers across the country. Approximately 90.8% of the participants indicated that they might offer or recommend ERCP in the management of RAP. Multinomial logistic regression analysis revealed that ductal dilatation and presence of symptoms were the most predictive variables (p<0.001) for offering ERCP. Conclusions A preponderance of the respondents would consider ERCP among patients with RAP presenting to tertiary care centers in the US. Ductal dilatation, presence of symptoms, and pancreas divisum significantly increased the likelihood of a recommendation for ERCP.http://www.e-ce.org/upload/pdf/ce-2019-052.pdfendoscopic retrograde cholangiopancreatographypancreas divisumpractice patternsrecurrent acute pancreatitis |
| spellingShingle | Jonathan B. Reichstein Vaishali Patel Parit Mekaroonkamol Sunil Dacha Steven A. Keilin Qiang Cai Field F. Willingham Practice Patterns and Use of Endoscopic Retrograde Cholangiopancreatography in the Management of Recurrent Acute Pancreatitis Clinical Endoscopy endoscopic retrograde cholangiopancreatography pancreas divisum practice patterns recurrent acute pancreatitis |
| title | Practice Patterns and Use of Endoscopic Retrograde Cholangiopancreatography in the Management of Recurrent Acute Pancreatitis |
| title_full | Practice Patterns and Use of Endoscopic Retrograde Cholangiopancreatography in the Management of Recurrent Acute Pancreatitis |
| title_fullStr | Practice Patterns and Use of Endoscopic Retrograde Cholangiopancreatography in the Management of Recurrent Acute Pancreatitis |
| title_full_unstemmed | Practice Patterns and Use of Endoscopic Retrograde Cholangiopancreatography in the Management of Recurrent Acute Pancreatitis |
| title_short | Practice Patterns and Use of Endoscopic Retrograde Cholangiopancreatography in the Management of Recurrent Acute Pancreatitis |
| title_sort | practice patterns and use of endoscopic retrograde cholangiopancreatography in the management of recurrent acute pancreatitis |
| topic | endoscopic retrograde cholangiopancreatography pancreas divisum practice patterns recurrent acute pancreatitis |
| url | http://www.e-ce.org/upload/pdf/ce-2019-052.pdf |
| work_keys_str_mv | AT jonathanbreichstein practicepatternsanduseofendoscopicretrogradecholangiopancreatographyinthemanagementofrecurrentacutepancreatitis AT vaishalipatel practicepatternsanduseofendoscopicretrogradecholangiopancreatographyinthemanagementofrecurrentacutepancreatitis AT paritmekaroonkamol practicepatternsanduseofendoscopicretrogradecholangiopancreatographyinthemanagementofrecurrentacutepancreatitis AT sunildacha practicepatternsanduseofendoscopicretrogradecholangiopancreatographyinthemanagementofrecurrentacutepancreatitis AT stevenakeilin practicepatternsanduseofendoscopicretrogradecholangiopancreatographyinthemanagementofrecurrentacutepancreatitis AT qiangcai practicepatternsanduseofendoscopicretrogradecholangiopancreatographyinthemanagementofrecurrentacutepancreatitis AT fieldfwillingham practicepatternsanduseofendoscopicretrogradecholangiopancreatographyinthemanagementofrecurrentacutepancreatitis |