Incidence Of PEP Research Articles

A meta-analysis of rectal NSAIDs in the prevention of post-ERCP pancreatitis

Background:Several pharmacological agents for the prevention of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) have been studied. Clinical trials evaluating the protective effect of non-steroidal anti-inflammatory drugs (NSAIDs) have yielded inconclusive...

Post- Endoscopic Retrograde Cholangiopancreatography Pancreatitis

Purpose: We conducted a retrospective study of patients hospitalized for the treatment of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) between April 1993 and March 2002, to investigate causative factors and reasons for exacerbation of PEP. Methods: 1. Comparative study based on classification by pancreatitis severity: We divided the cases into two groups (mild versus moderate and severe), based on the Japan Ministry of Health, Labour and Welfare classification of severity of pancreatitis. 2. Comparison between institutes with high and low rates of PEP: We divided institutes into two groups depending on the rate of PEP. Results: The rate of PEP remained constant. There were 57 cases of PEP among the total of 10717 ERCP cases, an occurrence rate of 0.532%. T here were significantly more cases in which contrast media was not excreted from the minor duodenal papilla than there were cases with this excretion. The time between the completion of ERCP and onset of abdominal pain was significantly shorter in the moderate and severe group than in the mild group. In contrast, the diagnosis was significantly delayed in the moderate and severe group, even though symptoms developed earlier. Other items that differed significantly between the two groups of institutes included whether or not patients were instructed to restrict alcohol and fat intake after the operation. Conclusions: The incidence of PEP has remained constant. To prevent the occurrence of PEP we must consider the high risk group. It is necessary to make the system of e early check up PEP and patients education.

6984 A dilated pancreatic duct at ercp can be associated with a lower incidence of post-ercp pancreatitis (pep).

Background: The etiology of PEP is probably multifactorial. Pancreatic stenting has been shown to reduce the incidence of PEP in selected patients. We hypothesized that normal diameter ducts are more likely to become occluded by edema and hence associated with PEP. The relationship between the findings of pancreatic ductography and PEP is not known. Aim: Evaluate if there is an association between pancreatic duct dilatation (PDIL) and PEP. Methods: The MUSC GI Trac database was reviewed for patients who had successful pancreatography. Patients with cancer, stricture, stones and prior pancreatic duct or orifice therapy were excluded. The incidence of PEP was evaluated in patients who did or did not have (PDIL). Patients were sub-grouped if they had a pancreatic stent placed and/or concomitant biliary sphincterotomy (BSx). Results: Of 3298 patients (mean age 49yrs., range 10-89yrs., M:F= 3:7), PEP occurred in 150 (5%). A dilated duct was noted in 801 patients. The incidence of PEP in all patients with PDIL was 3% (23/801) compared to 5% (127/2497) in those with no PDIL, p=0.008. The incidence of PEP in patients with and without BSx, pancreatic stenting and PDIL, is tabulated: Of all patients who had a pancreatic stent placed (n=887), there was no statistical difference in the incidence of PEP in those with PDIL (3%, 10/316) Vs no PDIL (5%, 27/571). CONCLUSIONS: 1] The overall incidence of PEP is lower if the pancreatic duct is dilated. 2] The presence of duct dilatation in patients who do not undergo BSx or PD stenting is associated with a lower incidence of PEP.

Causes, costs, and estimates of rabies postexposure prophylaxis treatments in the United States.

The incidence of rabies in humans in the United States is low. However, contacts with potentially rabid animals result in thousands of human rabies postexposure prophylaxis treatments (PEPs) each year. PEP is expensive, not without risk of adverse reactions, and in many instances unnecessary. Increased reports of cases of rabies in animals (4,880 cases in 1990, 9,495 in 1993, and 7,124 in 1996) suggested that PEPs could be increasing. Application of 1981 PEP incidence rates gave an estimate of approximately 16,000 PEPs during 1996, while calculations based on annual sales of a rabies biological during 1996 gave an estimate of approximately 39,000 PEPs. Appropriate usage of PEP requires careful evaluation of human exposure scenarios and adherence to approved guidelines.