Efficacy of Epinephrine Injection in Preventing Post-ERCP Pancreatitis

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dc.contributor.authorTorun, Serkan
dc.contributor.authorOdemis, Bulent
dc.contributor.authorCetin, Mehmet F.
dc.contributor.authorOnmez, Attila
dc.contributor.authorCoskun, Orhan
dc.date.accessioned2021-12-01T18:49:34Z
dc.date.available2021-12-01T18:49:34Z
dc.date.issued2021
dc.department[Belirlenecek]en_US
dc.description.abstractBackground: Rectal indomethacin or a topical spray of epinephrine to the papilla of Vater has each shown efficacy alone in the prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP). We supposed that a submucosal epinephrine injection would be more effective and longer acting than a topical epinephrine spray and therefore would further reduce the incidence of PEP. Patients and Methods: A retrospective analysis was conducted of 412 patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) between January 2017 and December 2019. These patients were divided into 2 groups: the indomethacin group and the indomethacin plus the submucosal epinephrine injection group. The incidence rates and severity of PEP, post-ERCP hyperamylasemia, other outcomes, and any other adverse events were compared between the groups. Results: Baseline demographic and clinical characteristics and procedure-related parameters were similar between the 2 groups. The incidence of PEP was 0.4% in the epinephrine group compared with 5.1% in the indomethacin group (P <0.001). Post-ERCP hyperamylasemia occurred in 24.6% of patients in the indomethacin group, whereas 7.6% of patients in the epinephrine group developed this condition; the difference was significant (P <0.001). Postsphincterotomy bleeding occurred in 5 patients, all of whom were in the indomethacin group (P < 0.001). Other adverse events, including arrhythmias, acute coronary events, stroke, or hypertension were not significantly different between the 2 groups. Conclusion: Addition of a submucosal epinephrine injection in conjunction with rectal indomethacin significantly reduced the incidence of PEP, post-ERCP hyperamylasemia, and post-sphincterotomy bleeding.en_US
dc.identifier.endpage214en_US
dc.identifier.issn1530-4515
dc.identifier.issn1534-4908
dc.identifier.issue2en_US
dc.identifier.scopus2-s2.0-85103683387en_US
dc.identifier.scopusqualityQ2en_US
dc.identifier.startpage208en_US
dc.identifier.urihttps://hdl.handle.net/20.500.12684/10743
dc.identifier.volume31en_US
dc.identifier.wosWOS:000647759700016en_US
dc.identifier.wosqualityQ4en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.language.isoenen_US
dc.publisherLippincott Williams & Wilkinsen_US
dc.relation.ispartofSurgical Laparoscopy Endoscopy & Percutaneous Techniquesen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectERCPen_US
dc.subjectpost-ERCP pancreatitisen_US
dc.subjectepinephrine hyperamylasemiaen_US
dc.subjectindomethacinen_US
dc.subjectEndoscopic Retrograde Cholangiopancreatographyen_US
dc.subjectRectal Indomethacinen_US
dc.subjectRandomized-Trialen_US
dc.subjectComplicationsen_US
dc.subjectSphincterotomyen_US
dc.subjectMetaanalysisen_US
dc.subjectProphylaxisen_US
dc.subjectIrrigationen_US
dc.subjectPapillaen_US
dc.subjectDamageen_US
dc.titleEfficacy of Epinephrine Injection in Preventing Post-ERCP Pancreatitisen_US
dc.typeArticleen_US

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