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Re: ERCP Advice

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Really not much you can do. This is a fairly recent article:

http://www.medscape.com/viewarticle/521049_4

In conclusion, multivariate analysis indicates that patient-related risk factors are as important as technical ones. Until effective, safe, and low-cost prophylactic drugs are definitively identified and made available, selective use in high-risk groups may be warranted. Unfortunately, such a drug is not available in the United States. Risk stratification will allow endoscopists to better identify patients who are at significant risk and permit detailed informed consent as well as possibly defer examinations in the highest-risk groups. Appropriate technical " prophylaxis " during ERCP, such as pancreatic ductal stenting, should also be carefully considered in high-risk patients to prevent the development of pancreatitis.

Arne

57 - UC 1977 - PSC 2000

Alive and well in Minnesota

________________________________

From: [mailto: ] On Behalf Of da_charters

...I am looking for any advice on how to reduce the likelyhood of getting

pancretitis. I know antibiotics pre-procedure is recommended, but what

about post?

Thanks for any advice.

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Really not much you can do. This is a fairly recent article:

http://www.medscape.com/viewarticle/521049_4

In conclusion, multivariate analysis indicates that patient-related risk factors are as important as technical ones. Until effective, safe, and low-cost prophylactic drugs are definitively identified and made available, selective use in high-risk groups may be warranted. Unfortunately, such a drug is not available in the United States. Risk stratification will allow endoscopists to better identify patients who are at significant risk and permit detailed informed consent as well as possibly defer examinations in the highest-risk groups. Appropriate technical " prophylaxis " during ERCP, such as pancreatic ductal stenting, should also be carefully considered in high-risk patients to prevent the development of pancreatitis.

Arne

57 - UC 1977 - PSC 2000

Alive and well in Minnesota

________________________________

From: [mailto: ] On Behalf Of da_charters

...I am looking for any advice on how to reduce the likelyhood of getting

pancretitis. I know antibiotics pre-procedure is recommended, but what

about post?

Thanks for any advice.

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Guest guest

Really not much you can do. This is a fairly recent article:

http://www.medscape.com/viewarticle/521049_4

In conclusion, multivariate analysis indicates that patient-related risk factors are as important as technical ones. Until effective, safe, and low-cost prophylactic drugs are definitively identified and made available, selective use in high-risk groups may be warranted. Unfortunately, such a drug is not available in the United States. Risk stratification will allow endoscopists to better identify patients who are at significant risk and permit detailed informed consent as well as possibly defer examinations in the highest-risk groups. Appropriate technical " prophylaxis " during ERCP, such as pancreatic ductal stenting, should also be carefully considered in high-risk patients to prevent the development of pancreatitis.

Arne

57 - UC 1977 - PSC 2000

Alive and well in Minnesota

________________________________

From: [mailto: ] On Behalf Of da_charters

...I am looking for any advice on how to reduce the likelyhood of getting

pancretitis. I know antibiotics pre-procedure is recommended, but what

about post?

Thanks for any advice.

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Guest guest

It is exactly as Arne, has indicated.

I have had ERCP's with and without pancreatitis. More ERCP's, without. Thank

God.

I usually take Cipro 1000mg, 3days prior. The test day i will be given Cipro

w/the IV and i think they include another antibiotic, too that i cannot recall.

If no pancreatitis, and i am released [usually next day or after], i would

continue for about a total of 10days i believe [3 prior and 7 post]. And even

though i did get pancreatitis, inspite of taking antiobiotics, i believe it is

better to start taking it even prior to the test. You know that i have learned

about the Pre-ERCP, CIPRO, from someone in this group and not from a doctor! And

also about a lot and lots of other things, too. Isn't that something?

I have one coming soon that was postponed twice. I do hope and pray that

everything will go o.k. I do dread them but i believe it is better to look in

there, at least annually.

Take Care.

Arne,

A very interesting research information. You are the expert in pancreatitis. And

of course you do help a lot in other issues, too. Thanks.

PSC/UC

Subject: RE: ERCP Advice

To:

Date: Friday, May 23, 2008, 12:01 AM

Really not much you can do. This is a fairly recent article:

http://www.medscape .com/viewarticle /521049_4

In conclusion, multivariate analysis indicates that patient-related risk factors

are as important as technical ones. Until effective, safe, and low-cost

prophylactic drugs are definitively identified and made available, selective use

in high-risk groups may be warranted. Unfortunately, such a drug is not

available in the United States. Risk stratification will allow endoscopists to

better identify patients who are at significant risk and permit detailed

informed consent as well as possibly defer examinations in the highest-risk

groups. Appropriate technical " prophylaxis " during ERCP, such as pancreatic

ductal stenting, should also be carefully considered in high-risk patients to

prevent the development of pancreatitis.

Arne

57 - UC 1977 - PSC 2000

Alive and well in Minnesota

____________ _________ _________ __

From: @ yahoogroups. com [mailto:@ yahoogroups. com] On

Behalf Of da_charters

...I am looking for any advice on how to reduce the likelyhood of getting

pancretitis. I know antibiotics pre-procedure is recommended, but what

about post?

Thanks for any advice.

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I have nevrer had pancreatitis post ERCP. I'm thankful especially since I had at least 15 ERCP's starting in 1982 with most being from 2002-2007. I only had antibiotics IV during the ERCP. I have experienced pancreatitis though but the docs didn't figure out what triggered it. HTH Blessings, Barby - KS UC - 1965, ileostomy - 1972, BCIR (continent pouch) 1994, PSC - 1995, arthritis 2007, tx 11.29.07married 28 years , 5 sons, 2 daughters in law, 1 granddaughter, 1 grandbaby due 10/08 and 1 golden retriever

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Jusat to let you know I have had 5 ERCP's beginning in July 07. I

have not had any problems so far. I believe that getting antibio

beforhand is a great help.

LEE G

>

> I am going in for my second ERCP in 6 months, the first of which

> identified that I had PSC. I got through the first one with no

> complications, but after reading posts on here the past number of

> months I see that many people have had the horrible experience of

> pancretitis after the ERCP.

>

> I am looking for any advice on how to reduce the likelyhood of

getting

> pancretitis. I know antibiotics pre-procedure is recommended, but

what

> about post?

>

> Thanks for any advice.

>

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I am just getting home from the hospital where I had another ERCP and a PTC at the same time......this really knocked me back some.....really tired...I have had 3 ERCP's since March and 1 different types of PTC's and I talked with a Liver Dr. at University of Wisconsin Hospital just today about having all these ERCP's.....I told him I was afraid of having so many and getting Pancretitis...he told me 'THE FIRST ERCP IS THE ONE THAT CAN CAUSE THE PROBLEMS......HE SAID THEY MAKE A CUT IN THAT ONE AND THAT IS THE DANGEROUS PART....ONCE YOU HAVE HAD ONE HE SAYS THEY JUST FOLLOW THE SAME TRACK AND GO THRO THE CUT THAT WAS MADE BEFORE...YOUR CHANCE OF INFECTION IS MUCH LESS AFTER THE FIRST ONE.....This made me feel better as if this brushing come back negative like the last one did then they are going to most likely do another ERCP and Brushing about every 6 months........they are watching me very close for cancer as he said I have 3 things going against me......1. PSC, 2. My age 59, 3. A stricture that has one of the ducts closed to the point they could not even get a wire the size of lead from a mechanical pencil through it......he said if I was 20 they would not be going at me as aggressively as they are now.....He said if they do get a positive brushing I have to have chemo and radiation then a liver transplant......This is really a scary time for us....Please keep us in your prayers as I am all of you.....Thanks, CJ

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Cheryl -- you got it -- all good thoughts coming your way!

Which duct was collapsed so badly? I found out Thursday that my right hepatic

duct is the

" problem. " I'll be facing MRCPs every 3-6 months and possibly another ERCP if

they think

they can get back in and do brushings. How is your CA 19-9? And Albumin?

In any event, rest up and be well,

Colleen

u/c 8/1984

psc 8/2000

Trying to be a Tigger-in-training!

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  • 2 weeks later...
Guest guest

I am responding only now because i was having an ERCP, 5days ago and i am just

starting to feel better from the after effects of sedatives---etc. Not that i

had a complication, thank God. I was very scared, although my previous one,

about 10mo ago was fine. So i wanted to add to Lee's statistics [Her ERCP's were

awsume knock on wood], that mine was without complications, and probably the

antib beforehand was a great help. Except for the sedatives, like always. But

this time it took a little more time, so i had to stay in the hospital 3 nights.

I did experience more nuasea and vomiting, this time, although they usuaslly

include Zophran in the IV. And i also was running a 101d fever the 2nd night,

that soon went down. I was put on post antibiotic for about 7 days, like

previous tests [a total of 10days].

PSC/UC

From: leegrilley@...

Subject: Re: ERCP Advice

To:

Date: Saturday, May 24, 2008, 4:42 AM

Jusat to let you know I have had 5 ERCP's beginning in July 07. I

have not had any problems so far. I believe that getting antibio

beforhand is a great help.

LEE G

I am going in for my second ERCP in 6 months, the first of which identified

that I had PSC. I got through the first one with no

complications, but after reading posts on here the past number of

months I see that many people have had the horrible experience of

pancretitis after the ERCP.

I am looking for any advice on how to reduce the likelyhood of

getting

pancretitis. I know antibiotics pre-procedure is recommended, but

what

about post?

Thanks for any advice.

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Share on other sites

Guest guest

I am responding only now because i was having an ERCP, 5days ago and i am just

starting to feel better from the after effects of sedatives---etc. Not that i

had a complication, thank God. I was very scared, although my previous one,

about 10mo ago was fine. So i wanted to add to Lee's statistics [Her ERCP's were

awsume knock on wood], that mine was without complications, and probably the

antib beforehand was a great help. Except for the sedatives, like always. But

this time it took a little more time, so i had to stay in the hospital 3 nights.

I did experience more nuasea and vomiting, this time, although they usuaslly

include Zophran in the IV. And i also was running a 101d fever the 2nd night,

that soon went down. I was put on post antibiotic for about 7 days, like

previous tests [a total of 10days].

PSC/UC

From: leegrilley@...

Subject: Re: ERCP Advice

To:

Date: Saturday, May 24, 2008, 4:42 AM

Jusat to let you know I have had 5 ERCP's beginning in July 07. I

have not had any problems so far. I believe that getting antibio

beforhand is a great help.

LEE G

I am going in for my second ERCP in 6 months, the first of which identified

that I had PSC. I got through the first one with no

complications, but after reading posts on here the past number of

months I see that many people have had the horrible experience of

pancretitis after the ERCP.

I am looking for any advice on how to reduce the likelyhood of

getting

pancretitis. I know antibiotics pre-procedure is recommended, but

what

about post?

Thanks for any advice.

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