• Acute pancreatitis
• Antibiotics
• Early phase
• Endoscopic retrograde cholangiopancreatography
• Fluid resuscitation
• Nutrition
• Pain

• Humans
• Pancreatitis/therapy
• Fluid Therapy/methods
• Cholangiopancreatography, Endoscopic Retrograde
• Anti-Bacterial Agents/therapeutic use
• Acute Disease
• Cholecystectomy

• Acute pancreatitis
• Choledocholithiasis
• biliary pancreatitis
• endoscopic retrograde cholangiopancreatography (ERCP)
• necrotizing pancreatitis
• recurrent acute pancreatitis

• biliary endoscopy
• emergency
• organization

• Humans
• Pancreatitis/therapy
• Acute Disease
• Severity of Illness Index

• acute pancreatitis
• endoscopic sphincterotomy
• endoscopy ercp
• gall stone disease (gsd)
• gallstone pancreatitis

• Humans
• Cholangiopancreatography, Endoscopic Retrograde/adverse effects
• Male
• Female
• Pancreatitis/etiology
• Cholangitis/etiology
• Middle Aged
• Retrospective Studies
• Aged
• Acute Disease
• Adult
• Pneumonia, Aspiration/etiology
• ROC Curve
• Hypotension/etiology
• Emergency Service, Hospital

• 2022-GNS-001 Seyoung Association (SYH), Department of Internal Medicine, Gangnam Severance Hospital
• HC21C0016 Patient-Centered Clinical Research Coordinating Center (PACEN), Ministry of Health & Welfare, Republic of Korea

• Biliary pancreatitis
• Choledocholithiasis
• ERCP
• Gallstone pancreatitis

• Humans
• Gallstones/complications
• Gallstones/diagnostic imaging
• Sewage
• Endoscopy, Gastrointestinal
• Pancreatitis/diagnostic imaging
• Pancreatitis/etiology
• Cholangitis/diagnostic imaging
• Cholangitis/etiology

This review summarized the current controversies in the management of acute pancreatitis (AP). The controversies in management range from issues involving fluid resuscitation, nutrition, the role of antibiotics and antifungals, which analgesic to use, role of anticoagulation and intervention for complications in AP. The interventions vary from percutaneous drainage, endoscopy or surgery. Active research and emerging data are helping to formulate better guidelines. The available evidence favors crystalloids, although the choice and type of fluid resuscitation is an area of dynamic research. The nutrition aspect does not have controversy as of now as early enteral feeding is preferred most often than not. The empirical use of antibiotics and antifungals are gray zones, and more data is needed for conclusive guidelines. The choice of analgesic is being studied, and the recommendations are still evolving. The position of using anticoagulation is still awaiting consensus. The role of intervention is well established, although the modality is constantly changing and favoring endoscopy or percutaneous drainage rather than surgery. It is evident that more multicenter randomized controlled trials are required for establishing the standard of care in these crucial management issues of AP to improve the morbidity and mortality worldwide.

• Acute pancreatitis
• Fluid resuscitation
• Antibiotics
• Analgesia
• Anti coagulation
• Intervention

• ERCP
• acute cholangitis
• biliary drainage
• endoscopic sphincterotomy
• gallstone pancreatitis

Endoscopic retrograde cholangiopancreatography (ERCP) has developed over the past few decades into a reliable technology for diagnostic and therapeutic purposes. Through a bibliometric analysis, this research attempted to evaluate the characteristics of the top 100 articles on ERCP that had the most citations.

We extracted pertinent publications from the Web of Science Core Collection (WoSCC) on July 9, 2022. The top 100 ERCP articles with the most citations were identified and analyzed. The following data were extracted: publication year, country/region, organization, total citation times, annual citation times, research type and research field, etc. To implement the network’s visual analysis, a bibliographic coupling network based on keywords was built using the VOSviewer 1.6.17 program.

The journal with the most publications were GASTROINTESTINAL ENDOSCOPY, with 45 articles. Most of the top 100 articles came from the United States (n = 47) and Italy (n = 14). Indiana University and the University of Amsterdam were among the most important institutions in ERCP research. ML Freeman of the University of Minnesota contributed the highest number (n = 9) and the most highly cited paper. The age of the paper and article type is closely related to citation frequency. Of the 100 most-cited articles, clinical application in the field of ERCP has focused on three aspects: diagnosis, treatment, and complications. Clinical use of ERCP has shifted from diagnosis to treatment. Post-ERCP pancreatitis is the focus of attention, and the clinical application of technically complex therapeutic ERCP is the future development trend.

This study lists the most influential articles in ERCP by exposing the current state of the field, and showing the evolution of research trends to provide perspective for the future development of ERCP.

• National Natural Science Foundation of China
• Youth Science Foundation of Jiangxi Province

• Pancreatitis bundles
• endoscopic intervention
• local pancreatic complications
• severity assessment
• step-up approach

• cholangitis
• endoscopic retrograde cholangiopancreatography
• meta-analysis
• mortality
• pancreatitis

• pancreas disease
• pancreatitis
• pancreatitis causes
• surgery
• surgical management of pancreatitis

• COVID-19
• Cholangiopancreatography, Endoscopic Retrograde/adverse effects
• Humans
• Pandemics
• SARS-CoV-2

• acute pancreatitis complications
• covid-19 impact on general surgery
• digestive organs/ liver/ pancreas
• pancreatitis demographics
• pancreatitis outcomes

The timing of endoscopic retrograde cholangiopancreatography (ERCP) in patients with acute biliary pancreatitis without cholangitis is unclear. We accessed a national database to analyze the outcomes of urgent (<24 h) and early (24-72 h) ERCP in this cohort.

The cohort was extracted from the Nationwide Inpatient Sample database. Hospital ERCP volumes were generated using unique hospital identifiers. Multivariate regression modeling was used to analyze the predictors of urgent vs. early ERCP use, and to determine various outcome variables between the 2 cohorts.

Overall, 105,433 admissions were evaluated. There was a significant rise in urgent ERCP performed over the study period. Older patients, males, patients with comorbidities, African American and Hispanic patient populations were less likely to receive urgent ERCP. High ERCP volume hospitals, teaching hospitals, and hospitals in the Midwest and West were more likely to perform urgent ERCP. There were no differences in mortality rates or complication rates between the 2 cohorts. However, there were significant differences in length of stay and healthcare cost analysis.

The increasing use of urgent ERCP did not result in a clinically significant benefit in terms of mortality, length of stay, or healthcare cost analysis. The use of urgent ERCP is also not uniform across various demographic and hospital cohorts. Urgent ERCP may be over-utilized, and it may be reasonable to perform ERCP in this patient population based on the physician’s suspicion about the severity of disease.

• Endoscopic retrograde cholangiopancreatography
• acute biliary pancreatitis
• national trends

Several researchers have used commercial microscope-integrated optical coherence tomography (OCT) systems in glaucoma surgery, including ab interno trabeculectomy and canaloplasty. However, the 840 nm wavelength light source of the OCT systems is not ideal for imaging the anterior chamber angle structures because of its limited penetration. We evaluated the potential value of a microscope-integrated swept-source OCT system with a 1,310 nm center-wavelength light in canaloplasty for glaucoma.

Sixteen porcine eyes were used to simulate canaloplasty. The critical surgical steps were monitored using a prototype microscope-integrated OCT system with a 1,310 nm light source and a high axial scan rate of 100 kHz. The images from swept-source OCT and three-dimensional images from the microscope were projected simultaneously onto a liquid crystal display three-dimensional monitor (LMD-4251TD, Sony, Japan). The changes in the collector vessel (aqueous drainage structure in the porcine eye, similar to Schlemm’s canal in humans) were measured using Image J software. Histological sections stained with hematoxylin and eosin were used to assess surgical efficacy.

High-resolution real-time images of the anterior segment were acquired during canaloplasty using the microscope-integrated OCT system. With the real-time OCT images, the position of the collector vessel was identified and the scleral flap could be created at the ideal location. The expansion of the collector vessel after viscoelastic injection was also visualized in real time. Compared with baseline, there was a significant increase in the cross-sectional area (from 14,502.98±9,242.55 to 59,499.04±20,506.41 µm², P<0.001) of the collector vessel.

Using the microscope-integrated OCT system, real-time images of the anterior segment were successfully acquired during the operation. The microscope-integrated OCT system might be useful in future anti-glaucoma surgery.

• Anterior segment
• MIOCT
• canaloplasty
• intraoperative real-time imaging

Acute pancreatitis (AP) is defined as an acute inflammatory attack of the pancreas of sudden onset. Around 25% of patients have either moderately severe or severe disease with a mortality rate of 15–20%.

The aim of this article was to summarize the advances being made in the understanding of this disease and the important role of surgery.

An accurate diagnosis should be made a soon as possible, initiating resuscitation with large volume intravenous fluids and oxygen by mask. Predicted severe disease will require intensive monitoring. Most deaths within the first week are due to multi-organ failure; thus, these patients will require intensive therapy unit management. During the second phase of the disease, death is due to local complications arising from the pancreatic inflammation, requiring accurate identification to determine the correct form of treatment. Acute peripancreatic fluid collections arise < 4 weeks after onset of interstitial edematous pancreatitis, not requiring any treatment. Most pancreatic pseudocysts arise > 4 weeks and largely resolve on conservative management. Necrotizing pancreatitis causing acute necrotic collections and later walled-off necrosis will require treatment if symptomatic or infected. Initial endoscopic transgastric or percutaneous drainage will resolve less serious collections but necrosectomy using minimally invasive approaches will be needed for more serious collections. To prevent recurrent attacks of AP, causative factors need to be removed where possible such as cholecystectomy and cessation of alcohol. Future progress requires improved management of multi-organ failure and more effective minimally invasive techniques for the removal of necrosis.

• Endoscopic
• Infection
• Minimally invasive surgery
• Necrosectomy
• Pancreatic necrosis
• Percutaneous

• COVID-19
• ERCP (endoscopic retrograde cholangiopancreatography)
• Healthcare workers (HCW)
• personal protection equipment (PPE)
• post-coronavirus outbreak

• Acute Disease
• Aged
• Cholangiopancreatography, Endoscopic Retrograde/methods
• Combined Modality Therapy
• Conservative Treatment/methods
• Female
• Gallstones/complications
• Gallstones/etiology
• Gallstones/therapy
• Humans
• Male
• Pancreatitis/therapy
• Sphincterotomy, Endoscopic/methods
• Treatment Outcome

• Cholangiopancreatography, Endoscopic Retrograde
• Conservative Treatment
• Gallstones
• Humans
• Pancreatitis
• Sphincterotomy

• Acute Disease
• Conservative Treatment/methods
• Disease Management
• Drainage/methods
• Endoscopy/methods
• Humans
• Pancreatitis/diagnosis
• Pancreatitis/therapy
• Progressive Patient Care/methods

Endoscopic retrograde cholangiopancreatography (ERCP) is the gold standard treatment for pancreaticobiliary diseases. The aim of this study was to evaluate the safety and review the outcomes of our experience of ERCP over the past 4 years.

The clinical records of patients aged 18-104 years who underwent ERCP at our gastroenterology clinic between 2014 and 2018 were included in the study. Data were acquired from the hospital archive system.

A total of 1337 patients with a mean age of 60.58±17.96 years. including 775 female, and 562 male cases were included in the study. The patients were in the age groups of 18-30 (n=39), 30-65 (n=694), 65-75 (n=274), 75-85 (n=258), and > 85 (n=72) years. Among them, 28.27% were rated as ASA III-IV on the American Society of Anesthesiologists scale. Although biliary cannulation with standard sphincterotomy was successful in 1303 (97.45%), patients it could not be performed in 34 (2.55%). patients Precut papillotomy was performed in 27 (79.41%) of 34 patients. Furthermore, no complication was observed in 1207 patients (90.27%), whereas 96 patients (7.18%) had minor and major procedure-related and anesthesia-related complications. The 30-day mortality rate was 1.64% (n=22).

We concluded that ERCP, which is currently performed entirely for therapeutic purposes, is safe and lifesaving, with high clinical success rates.

• ERCP
• complications
• outcomes
• pancreaticobiliary diseases

• Acute pancreatitis
• Audit
• Epidemiology
• Management

• Adult
• Age Factors
• Aged
• Aged, 80 and over
• Alcohol Drinking/adverse effects
• Cholangiopancreatography, Endoscopic Retrograde/adverse effects
• Critical Care/methods
• Critical Care/standards
• England/epidemiology
• Female
• Gallstones/complications
• Gallstones/therapy
• Humans
• Incidence
• Length of Stay/statistics & numerical data
• Male
• Medical Audit/statistics & numerical data
• Middle Aged
• Pancreatitis/diagnosis
• Pancreatitis/epidemiology
• Pancreatitis/etiology
• Pancreatitis/therapy
• Patient Admission/statistics & numerical data
• Practice Guidelines as Topic
• Prospective Studies
• Severity of Illness Index
• Survival Rate
• Treatment Outcome
• Young Adult

• Cholangiopancreatography, Endoscopic Retrograde
• Cholangiopancreatography, Magnetic Resonance
• Cholecystectomy
• Choledocholithiasis/diagnosis
• Choledocholithiasis/therapy
• Endosonography
• Humans
• Mirizzi Syndrome/diagnosis
• Mirizzi Syndrome/therapy
• Sphincterotomy, Endoscopic
• Stents

• U01 DK108334 NIDDK NIH HHS

• acute pancreatitis
• ercp
• gallstones
• cholecystectomy
• resuscitation
• sirs

• Acute Disease
• Enteral Nutrition
• Fluid Therapy
• Humans
• Pancreatitis/diagnosis
• Pancreatitis/etiology
• Pancreatitis/therapy
• Patient Care Management
• Time Factors
• Triage

• KL2 TR001109 NCATS NIH HHS
• T32 DK007634 NIDDK NIH HHS

• Acute biliary pancreatitis
• Endoscopic retrograde cholangiopancreatography
• Pancreatic stenting

• Acute pancreatitis
• alcohol
• cannabis
• cholecystectomy
• ercp
• feeding
• gallstones
• goal directed fluid therapy
• smoking

This review highlights advances made in recent years in the diagnosis and management of acute pancreatitis (AP). We focus on epidemiological, clinical, and management aspects of AP. Additionally, we discuss the role of using risk stratification tools to guide clinical decision making. The majority of patients suffer from mild AP, and only a subset develop moderately severe AP, defined as a pancreatic local complication, or severe AP, defined as persistent organ failure. In mild AP, management typically involves diagnostic evaluation and supportive care resulting usually in a short hospital length of stay (LOS). In severe AP, a multidisciplinary approach is warranted to minimize morbidity and mortality over the course of a protracted hospital LOS. Based on evidence from guideline recommendations, we discuss five treatment interventions, including intravenous fluid resuscitation, feeding, prophylactic antibiotics, probiotics, and timing of endoscopic retrograde cholangiopancreatography (ERCP) in acute biliary pancreatitis. This review also highlights the importance of preventive interventions to reduce hospital readmission or prevent pancreatitis, including alcohol and smoking cessation, same-admission cholecystectomy for acute biliary pancreatitis, and chemoprevention and fluid administration for post-ERCP pancreatitis. Our review aims to consolidate guideline recommendations and high-quality studies published in recent years to guide the management of AP and highlight areas in need of research.

• Acute pancreatitis
• alcohol
• cannabis
• cholecystectomy
• ercp
• feeding
• gallstones
• goal directed fluid therapy
• smoking

Acute pancreatitis is a common diagnosis worldwide, with gallstone disease being the most prevalent cause (50%). The American College of Gastroenterology recommends urgent endoscopic retrograde cholangiopancreatography (ERCP) (within 24 h) for patients with biliary pancreatitis accompanied by cholangitis. Most international guidelines recommend that ERCP be performed within 72 h in patients with biliary pancreatitis and a bile duct obstruction without cholangitis, but the optimal timing for endoscopy is controversial. We investigated the optimal timing for ERCP in patients with biliary pancreatitis and a bile duct obstruction without cholangitis, and whether performing endoscopy within 24 h is superior to performing it after 24 h. We analyzed the clinical data of 505 patients with newly diagnosed acute pancreatitis, from January 1, 2005 to December 31, 2014. We divided the patients into two groups according to the timing of ERCP: < 24 h (urgent) and 24–72 h (early).Among the 505 patients, 73 were diagnosed with biliary pancreatitis and a bile duct obstruction without cholangitis. The mean age of the patients was 55 years (range: 26–90 years). Bile duct stones and biliary sludge were identified on endoscopy in 45 (61.6%) and 11 (15.0%) patients, respectively. The timing of ERCP within 72 h was not associated with ERCP-related complications (P = 0.113), and the total length of hospital stay was not different between urgent and early ERCP (5.9 vs. 5.7 days, P = 0.174). No significant differences were found in total length of hospitalization or procedural-related complications, in patients with biliary pancreatitis and a bile duct obstruction without cholangitis, according to the timing of ERCP (< 24 h vs. 24–72 h).

• Acute Disease
• Adult
• Aged
• Aged, 80 and over
• Cholangiopancreatography, Endoscopic Retrograde/adverse effects
• Cholangiopancreatography, Endoscopic Retrograde/methods
• Cholangitis/complications
• Cholestasis/complications
• Cholestasis/diagnosis
• Cholestasis/surgery
• Female
• Humans
• Length of Stay
• Male
• Middle Aged
• Pancreatitis/diagnosis
• Pancreatitis/etiology
• Pancreatitis/surgery
• Republic of Korea
• Retrospective Studies
• Time Factors

• Acute biliary pancreatitis (ABP)
• Common bile duct (CBD) stone
• Magnetic resonance cholangiopancreatography (MRCP)

• acute pancreatitis
• classification
• diagnosis
• review
• treatment

• Cholecystectomy
• Gallstone pancreatitis
• Pediatric cholecystectomy

• Acute Disease
• Adolescent
• Child
• Child, Preschool
• Cholecystectomy/methods
• Female
• Follow-Up Studies
• Gallstones/complications
• Gallstones/surgery
• Humans
• Infant
• Male
• Pancreatitis/etiology
• Pancreatitis/surgery
• Patient Readmission/statistics & numerical data
• Recurrence
• Retrospective Studies
• Time Factors
• Treatment Outcome

• Acute pancreatitis
• Antibiotics
• Endoscopic treatment
• Enteral feeding
• Fluid resuscitation
• Pain management

• Cholecystectomy
• Gallstones
• Pancreatitis
• Recurrent pancreatobiliary complications

• Acute pancreatitis
• Cholecystectomy
• Endoscopic retrograde cholangiopancreatography
• Endoscopic sphincterotomy
• Gallstones

Interleukin (IL)-6, IL-8, IL-10, and C-reactive protein (CRP) have been evaluated for predicting outcomes of acute pancreatitis. However, there is considerable variation in their performance among different studies. We evaluate their accuracy in predicting progression to severe pancreatitis.

Serum IL-6, IL-8, IL-10, and CRP levels were measured within 24 h of admission in forty patients of clinically predicted severe acute pancreatitis (SAP). Persistent organ failure (>48 h) defined SAP. The performance of inflammatory markers was evaluated in predicting the progression of pancreatitis.

IL-6 ≥28.90 pg/mL had a sensitivity of 62.86%, specificity of 80%, positive predictive value (PPV) of 95.65%, LR+ of 3.1429, LR− of 0.4643, and diagnostic odds ratio (DOR) of 6.7692; IL-8 ≥88.70 pg/mL had a sensitivity of 60%, specificity of 80%, PPV of 95.45%, LR+ of 3.000, LR− of 0.5000, and DOR of 6.000; IL-10 ≤5.70 pg/mL had DOR of 0.2647, sensitivity of 51.43%, specificity of 20%, PPV of 81.82%, LR+ of 0.6429, and LR− of 2.4286. CRP ≥110.00 mg/L had DOR of 2.3636, sensitivity of 37.14%, specificity of 80%, PPV of 92.86%, LR+ of 1.8571, and LR of 0.7857.

IL-6 ≥28.90 pg/mL, measured within 48 h of onset is the best among the tested biomarkers in this study for predicting the progression to severe pancreatitis.

• Inflammatory cytokines
• interleukins
• predictive markers
• severe acute pancreatitis