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Current Issue May 2015

Prophylactic somatostatin can reduce incidence of post-ERCP pancreatitis: multicenter randomized controlled trial  (FREE ACCESS)

Yu Bai, Xu Ren, Xiao-Feng Zhang, Nong-Hua Lv, Xue-Gang Guo, Xin-Jian Wan, Zhan-Guo Nie, Shu-Tang Han, Ping Bie, De-An Tian, Ming Ji, Zhao-Shen Li

In a multicenter, randomized controlled trial (n=900), the authors showed that somatostatin (250μg bolus injection before endoscopic retrograde cholangiopancreatography (ERCP) plus 250μg/hour intravenous infusion for 11 hours after ERCP) significantly (P=0.03) reduced the occurrence of post-ERCP pancreatitis (4.0% vs. 7.5%) and hyperamylasemia (6.1% vs. 10.1 %) compared with controls (no treatments). The consequence, however, was that patients required extended hospital admission in order to complete somatostatin infusion. Read more.

Early use of double-guidewire technique to facilitate selective bile duct cannulation:
the multicenter randomized controlled trial  (FREE ACCESS)


Naoki Sasahira, Hiroshi Kawakami, Hiroyuki Isayama, Rie Uchino, Yousuke Nakai, Yukiko Ito, Saburo Matsubara, Hirotoshi Ishiwatari, Minoru Uebayashi, Hiroshi Yagioka, Osamu Togawa, Nobuo Toda, Naoya Sakamoto, Junji Kato, Kazuhiko Koike

It is unclear whether use of the double-guidewire technique facilitates selective bile duct cannulation during endoscopic retrograde cholangiopancreatography (ERCP) and reduces post-ERCP pancreatitis as compared with repeated single-guidewire cannulation. In a large prospective randomized study, Sasahira et al. concluded that the success of selective bile duct cannulation was similar with the two methods (early use of the double-guidewire method 98%, repeated single-guidewire method 97%). The corresponding post-ERCP pancreatitis rates were 20% and 17%; however, the double-guidewire technique was more effective in malignant biliary strictures. Read more.

Confocal laser endomicroscopy for the differential diagnosis of ulcerative colitis and Crohn's disease: a pilot study  (FREE ACCESS)

Gian Eugenio Tontini, Jonas Mudter, Michael Vieth, Raja Atreya, Claudia Günther, Yurdagül Zopf, Dane Wildner, Ralf Kiesslich, Maurizio Vecchi, Markus F. Neurath, Helmut Neumann

This prospective pilot study assessed the utility of confocal laser endomicroscopy in inflammatory bowel disease. Crohn's disease was more often associated with discontinuous inflammation (87.5% vs. 5.1 %), focal cryptitis (75.0% vs. 12.8 %), and discontinuous crypt architectural abnormality (87.5% vs. 10.3%), whereas ulcerative colitis was more often associated with widespread crypt distortion (87.2% vs. 17.5%), decreased crypt density (79.5% vs. 22.5 %), and a frankly irregular surface (89.7% vs. 17.5%). It was concluded that confocal laser endomicroscopy is useful to differentiate between Crohn's disease and ulcerative colitis. Read more.