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Extracorporeal shock wave lithotripsy for pancreatic duct stones: an observational study.

https://arctichealth.org/en/permalink/ahliterature299471
Source
Scand J Gastroenterol. 2018 Oct - Nov; 53(10-11):1399-1403
Publication Type
Journal Article
Observational Study
Author
Stefan Haraldsson
Stine Roug
Camilla Nøjgaard
Srdan Novovic
Lise Lotte Gluud
Erik Feldager
Palle Nordblad Schmidt
Author Affiliation
a Department of Gastroenterology , Landspitali - University Hospital , Reykjavik , Iceland.
Source
Scand J Gastroenterol. 2018 Oct - Nov; 53(10-11):1399-1403
Language
English
Publication Type
Journal Article
Observational Study
Keywords
Adult
Aged
Analgesics, Opioid - therapeutic use
Denmark
Extracorporeal Shockwave Therapy
Female
Gallstones - therapy
Humans
Lithotripsy - instrumentation - methods
Logistic Models
Male
Middle Aged
Multivariate Analysis
Pain - drug therapy - etiology
Pancreatic Diseases - therapy
Pancreatic Ducts - pathology
Retrospective Studies
Treatment Outcome
Abstract
Previous studies suggest that fragmentation of pancreatic duct stones (PDS) using extracorporeal shock wave lithotripsy (ESWL) is associated with pain relief. However, the treatment may not be effective in certain subgroups.
To evaluate predictors of pain relief after ESWL in patients with chronic pancreatitis and PDS.
Retrospective study including patients with chronic pancreatitis undergoing ESWL for painful PDS. Analgesic use before and after the ESWL procedure was registered. We defined adequate pain relief after ESWL as 'pain-free without analgesics or with use of weak analgesics as needed'. The study was approved by the Danish Data Protection Agency (approval number: AHH-2017-048).
We included 81 patients (median age 58 years; 63% men; 68% alcoholic pancreatitis). Patients underwent one to seven ESWL procedures (mean 1.7). A concurrent ERCP was performed in 17%. All patients used analgesics before the ESWL procedure (68 used opioids). After ESWL, 43 still used opioids. Thirty-two patients achieved adequate pain relief. Univariable regression analysis showed that older age predicted adequate pain relief (OR 1.09;1.03-1.16; p?=?.002) as did location of the stone in the head or neck (OR 2.59;1.04-6.45; p?=?.041). In multivariable analysis, we found that the only two predictors of adequate pain relief were age (p?=?.002) and the location of the stones (p?=?.039).
After the ESWL, about four out of ten patients are pain-free without medication or able to manage their pain with weak analgesics. Age and the location of the stones may be considered when evaluating if patients are eligible for referral to ESWL.
PubMed ID
30353766 View in PubMed
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How to cannulate? A survey of the Scandinavian Association for Digestive Endoscopy (SADE) in 141 endoscopists.

https://arctichealth.org/en/permalink/ahliterature125144
Source
Scand J Gastroenterol. 2012 Jul;47(7):861-9
Publication Type
Article
Date
Jul-2012
Author
J-Matthias Löhr
Lars Aabaken
Urban Arnelo
Juha Grönroos
Jorma Halttunen
Truls Hauge
Eduard Jonas
Per M Kleveland
Palle Nordblad Schmidt
Fredrik Swahn
Arto Saarela
Ervin Toth
Søren Meisner
Author Affiliation
Gastrocentrum Kirurgi, Karolinska Universitetssjukhuset, Stockholm, Sweden. matthias.lohr@ki.se
Source
Scand J Gastroenterol. 2012 Jul;47(7):861-9
Date
Jul-2012
Language
English
Publication Type
Article
Keywords
Bile Ducts
Cholangiopancreatography, Endoscopic Retrograde - instrumentation - methods
Clinical Competence
Gastroenterology
Humans
Physician's Practice Patterns
Questionnaires
Scandinavia
Abstract
Cannulation of the papilla vateri represents an enigmatic first step in endoscopic retrograde cholangiopancreaticography (ERCP). In light of falling numbers of (diagnostic) ERCP and novel techniques, e.g. short-wire system, we were interested in the approach novice and experienced endoscopist are taking; especially, what makes a papilla difficult to cannulate and how to approach this. We devised a structured online questionnaire, sent to all endoscopists registered with SADE, the Scandinavian Association for Digestive Endoscopy. A total of 141 responded. Of those, 49 were experienced ERCP-endoscopists (>900 ERCPs). The first choice of cannulation is with a sphincterotome and a preinserted wire. Both less experienced and more experienced endoscopists agreed on the criteria to describe a papilla difficult to cannulate and both would choose the needle-knife sphincterotomy (NKS) to get access to the bile duct. The less experienced used more "upward" NKS, whereas the more experienced also used the "downward" NKS technique. This survey provides us with a database allowing now for a more differentiated view on cannulation techniques, success, and outcome in terms of pancreatitis.
PubMed ID
22512404 View in PubMed
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[The quality of colonoscopy in Denmark. Results from a European quality study].

https://arctichealth.org/en/permalink/ahliterature174762
Source
Ugeskr Laeger. 2005 Apr 18;167(16):1733-7
Publication Type
Article
Date
Apr-18-2005
Author
Palle Nordblad Schmidt
Jane Møller Hansen
Peter Bytzer
Hans Jørgen Gyrtrup
Peter Matzen
Author Affiliation
H:S Hvidovre Hospital, Gastroenheden.
Source
Ugeskr Laeger. 2005 Apr 18;167(16):1733-7
Date
Apr-18-2005
Language
Danish
Publication Type
Article
Keywords
Adult
Clinical Competence
Colonoscopy - methods - standards - statistics & numerical data
Denmark
Europe
Female
Gastroenterology - education
Humans
Male
Middle Aged
Prospective Studies
Notes
Comment In: Ugeskr Laeger. 2005 Apr 18;167(16):172315898597
PubMed ID
15898601 View in PubMed
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