Most Read Articles
Roshini Claire Anthony, 2 days ago

The combined use of piperacillin and tazobactam does not appear to be a suitable alternative to meropenem for patients with bloodstream infections caused by ceftriaxone-resistant Escherichia coli (E. coli) or Klebsiella pneumoniae (K. pneumoniae), according to results of the MERINO* trial.

Tristan Manalac, 5 days ago
Taking oral antibiotics appears to increase the risk of nephrolithiasis, according to a recent study. Moreover, the risk seems to be compounded for individuals with recent antibiotic exposure and those who were exposed at a younger age.
Jairia Dela Cruz, 6 days ago
Male smokers under the age of 50 years are at risk of developing ischaemic stroke, and this risk increases with the number of cigarettes smoked daily, according to data from the Stroke Prevention in Young Men Study.
Yesterday
Early renin-angiotensin-aldosterone system (RAAS) blockade with renin-angiotensin system inhibitors (RASI) leads to better short- and long-term renal outcomes in systemic lupus erythematosus (SLE) patients with antiphospholipid-associated nephropathy (aPLN), according to a study, adding that this renal protective effect is independent of RASI’s antihypertensive and antiproteinuric effects.

Urgent repeat ERCP hints at plastic stent failure

19 Jan 2018
Canadian gambles to save his life and flies to Hong Kong for liver transplant with his wife as living donor.

It appears that urgent repeat endoscopic retrograde cholangiopancreatography (ERCP) predicts failure of plastic stent treatment for biliary strictures (BS) following liver transplant, according to a study.

Overall, 31 patients met the inclusion criteria. Of these, 24 (77.4 percent) resolved with plastic stenting and seven needed surgery.

No significant differences were observed between stent responders and nonresponders with respect to demographics, transplant and postoperative hospitalization data, time from transplantation to presentation with stricture, total number of ERCP sessions, or maximal number of stents.

There was a trend toward a difference in the time elapsed between the first and the second ERCP, in which a second procedure was performed among ERCP nonresponders sooner than responders. Patients who underwent the second procedure as scheduled had a 95-percent endoscopic success rate, while those who presented urgently with acute cholangitis had a 55-percent failure rate (p=0.02).

“This finding may assist earlier triage of these patients toward alternative treatment such as metal stents or surgery, thus sparing needless procedures and complications,” the investigators said.

To identify predictors of response or failure of standard, endoscopic treatment, the investigators performed a retrospective review of the Database of Gastroenterology Department at Tel Aviv Medical Center and analysed data regarding patients who underwent liver transplantation and developed BS.

BS is a common complication of liver transplantation, and the standard treatment is sequential insertion of increasing numbers of plastic stents by ERCP. However, despite high success rates, some strictures fail to resolve and require surgery as definitive treatment, according to the investigators.

Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Doctor - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
Roshini Claire Anthony, 2 days ago

The combined use of piperacillin and tazobactam does not appear to be a suitable alternative to meropenem for patients with bloodstream infections caused by ceftriaxone-resistant Escherichia coli (E. coli) or Klebsiella pneumoniae (K. pneumoniae), according to results of the MERINO* trial.

Tristan Manalac, 5 days ago
Taking oral antibiotics appears to increase the risk of nephrolithiasis, according to a recent study. Moreover, the risk seems to be compounded for individuals with recent antibiotic exposure and those who were exposed at a younger age.
Jairia Dela Cruz, 6 days ago
Male smokers under the age of 50 years are at risk of developing ischaemic stroke, and this risk increases with the number of cigarettes smoked daily, according to data from the Stroke Prevention in Young Men Study.
Yesterday
Early renin-angiotensin-aldosterone system (RAAS) blockade with renin-angiotensin system inhibitors (RASI) leads to better short- and long-term renal outcomes in systemic lupus erythematosus (SLE) patients with antiphospholipid-associated nephropathy (aPLN), according to a study, adding that this renal protective effect is independent of RASI’s antihypertensive and antiproteinuric effects.