| Theme | Indications and Standards of Practice for Emergency Endoscopy | |
|---|---|---|
| Title | Emergency Endoscopic Procedures for Acute Pancreatic Disorders | |
| Publish Date | 2018/05 | |
| Author | Yukiko Takigawa | Center for Gastroenterology, Teine-keijinkai Hospital |
| Author | Akio Katanuma | Center for Gastroenterology, Teine-keijinkai Hospital |
| Author | Kuniyuki Takahashi | Center for Gastroenterology, Teine-keijinkai Hospital |
| Author | Tsuyoshi Hayashi | Center for Gastroenterology, Teine-keijinkai Hospital |
| Author | Kei Yane | Center for Gastroenterology, Teine-keijinkai Hospital |
| Author | Toshifumi Kin | Center for Gastroenterology, Teine-keijinkai Hospital |
| [ Summary ] | Patients presenting with acute pancreatic disorders such as biliary pancreatitis, acute obstructive pancreatic ductitis (AOPD), and traumatic pancreatic injury are usually required to undergo emergency endoscopic procedures for optimal management. Biliary pancreatitis is the most common type of acute pancreatitis. Patients with biliary obstruction are required to undergo an emergency endoscopic procedure. AOPD could occur in patients with obstruction of the main pancreatic duct and could cause severe inflammation as is noted with sepsis. In such cases, pancreatic drainage is an effective treatment. Regarding traumatic pancreatic injury, an important consideration to decide the optimal treatment strategy involves an accurate examination to determine the extent of the main pancreatic duct injury. Pancreatography is the most effective modality to determine the type of pancreatic duct injury. In patients presenting with pancreatic duct injury, surgery should be the first-line treatment strategy; however, in a few patients the placement of a pancreatic stent could obviate the need for surgery. Endoscopic procedures could be a useful treatment modality in those with pancreatic injury. | |