{"id":2378,"date":"2014-01-15T15:41:38","date_gmt":"2014-01-15T15:41:38","guid":{"rendered":"https:\/\/medicalcriteria.com\/web\/gasercp\/"},"modified":"2025-05-13T20:27:47","modified_gmt":"2025-05-13T20:27:47","slug":"gasercp","status":"publish","type":"post","link":"https:\/\/medicalcriteria.com\/web\/gasercp\/","title":{"rendered":"Indications and Contraindications for ERCP in Patients with Acute Biliary Pancreatitis"},"content":{"rendered":"<div class=\"99c380e4b4a7b96c35d7ddf7dcb434e8\" data-index=\"1\" style=\"float: none; margin:0px 0 0px 0; text-align:center;\">\n<script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script>\r\n<!-- MC 2019- Horizontal -->\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-client=\"ca-pub-0127150553352455\"\r\n     data-ad-slot=\"3806776041\"\r\n     data-ad-format=\"auto\"\r\n     data-full-width-responsive=\"true\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script>\n<\/div>\n<p>Recent guidelines published by the American College of Gastroenterology suggest that urgent endoscopic retrograde cholangiopancreatography (ERCP) (within 24 hours after admission) is indicated in patients with biliary pancreatitis who have concurrent acute cholangitis, but it is not needed in most patients who do not have evidence of ongoing biliary obstruction.<br \/>\n<!--more--><br \/>\n<span style=\"line-height: 1.3em;\"><strong>Indications and Contraindications for ERCP in Patients with Acute Biliary Pancreatitis<\/strong><\/span><br \/>\n<strong style=\"line-height: 1.3em;\"><br \/>\nIndications<\/strong><br \/>\nSuspected bile-duct stones as the cause of pancreatitis established clinically,\u00a0<span style=\"line-height: 1.3em;\">and one of the following:<\/span><\/p>\n<ul>\n<li><span style=\"line-height: 1.3em;\">Cholangitis (fever, jaundice, sepsis)<\/span><\/li>\n<li><span style=\"line-height: 1.3em;\">Persistent biliary obstruction (conjugated bilirubin level &gt;5 mg\/dl <\/span><span style=\"line-height: 1.3em;\">[86 \u00b5mol per liter])<\/span><\/li>\n<li><span style=\"line-height: 1.3em;\">Clinical deterioration (worsening pain, increasing white-cell count, <\/span><span style=\"line-height: 1.3em;\">worsening vital signs)<\/span><\/li>\n<li><span style=\"line-height: 1.3em;\">Stone detected in the common bile duct on imaging<\/span><\/li>\n<\/ul>\n<p><strong>Contraindications<\/strong><br \/>\nAbsolute<\/p>\n<ul>\n<li><span style=\"line-height: 1.3em;\">Unstable medical condition precluding safe administration of moderate <\/span><span style=\"line-height: 1.3em;\">sedation or general anesthesia<\/span><\/li>\n<li><span style=\"line-height: 1.3em;\">Decision by competent patient not to provide consent for the procedure<\/span><\/li>\n<li><span style=\"line-height: 1.3em;\">Endoscopist with inadequate training in ERCP<\/span><\/li>\n<\/ul>\n<p>Relative (may be overcome)<\/p>\n<ul>\n<li><span style=\"line-height: 1.3em;\">Anatomical condition (gastroduodenal disease or surgical alteration) <\/span><span style=\"line-height: 1.3em;\">that would impede endoscopic access to the major papilla; may be <\/span><span style=\"line-height: 1.3em;\">overcome in the case of a long Roux limb, for example, with the use of <\/span><span style=\"line-height: 1.3em;\">modified equipment and accessories<\/span><\/li>\n<li><span style=\"line-height: 1.3em;\">Clinically significant or uncorrectable coagulopathy; may be overcome, <\/span><span style=\"line-height: 1.3em;\">since a biliary stent can be placed without need for sphincterotomy<\/span><\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><strong>References:<\/strong><\/p>\n<ol>\n<li>Fogel EL, Sherman S. ERCP for gallstone pancreatitis. N Engl J Med. 2014 Jan 9;370(2):150-7.\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/24401052\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>Canlas KR, Branch MS. Role of endoscopic retrograde cholangiopancreatography in acute pancreatitis. World J Gastroenterol. 2007 Dec 21;13(47):6314-20.<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/18081218\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p>Created Jan 15, 2014.<\/p>\n\n<div style=\"font-size: 0px; height: 0px; line-height: 0px; margin: 0; padding: 0; clear: both;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>Sorry, this entry is only available in Espa\u00f1ol.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"","_lmt_disable":"","_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[53],"tags":[231,230,1007,1006,1005,1004,1003,1002,74,73,990,1008],"class_list":["post-2378","post","type-post","status-publish","format-standard","hentry","category-gastroenterology","tag-acute","tag-aguda","tag-biliar","tag-biliary","tag-contraindicaciones","tag-contraindications","tag-cpre","tag-ercp","tag-indicaciones","tag-indications","tag-pacientes","tag-pancreatitis"],"modified_by":"Guillermo Firman","_links":{"self":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2378","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/comments?post=2378"}],"version-history":[{"count":3,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2378\/revisions"}],"predecessor-version":[{"id":8736,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2378\/revisions\/8736"}],"wp:attachment":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/media?parent=2378"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/categories?post=2378"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/tags?post=2378"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}