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1. The Incidence Rate of Post-ERCP Pancreatitis and Its Related Factors

Author

Seyed Saeid Sarkeshikian and Ahmad Hormati

Subjects
pancreatitis, incidence, risk factors, protective factors, serum amylase, Medicine (General), R5-920
Abstract

Background and Objectives: ERCP is a specific technique, which allows bile and pancreatic duct imaging along with a variety of therapeutic interventions. The complexity of this technique has led to a challenge between its benefits and its serious or even mortal complications, among which, pancreatitis is the most common. The aim of this study was to assess the incidence, risk factors, and protective factors of this complication. Methods: In this cross-sectional study, the research population was 310 individuals who referred to Gastroenterology and Hepatology Research Centre of Qom city. At the beginning of the study, demographic characteristics, medical history, and necessary laboratory results of the participants, were recorded and then they underwent ERCP. After 6 hours, physical examination was performed and serum amylase level was evaluated. Six hours after the procedure, the results of examination and amylase test were recorded. Data were analyzed using non-parametric Chi-square and parametric paired t-test. Results: The incidence of pancreatitis was 8.1% and mortality rate was 0.9%; %34 of the patients had hyperamylasemia. Cannulation was difficult, and the number of pancreatic duct cannulation was reported as a risk factor. The mean serum amylase level after ERCP, showed a significant increase in patients with pancreatitis. Conclusion: In this study, the incidence of pancreatitis was 8.1% and the mortality rate was 0.9%, which were similar to previous studies, but the protective role of pancreatic duct stenting was not confirmed. Also, pancreatic duct cannulation and its multiplicity was obvious risk factors. The serum amylase level had a definite association with clinical pancreatitis. More experience of endoscopist and improvement of device function reduced the risk of pancreatitis. Therefore, the serum level of amylase is a reliable factor for diagnosis of this complication.

Published
2017

2. A 41-Year-Old Man with Two Types of Metachronous Peptic Ulcer Complication due to Zollinger-Ellison Syndrome—Regression of Pancreatic Primary after Chemoembolization of Hepatic Metastases: A Case Report

Author

Seyed Saeid Sarkeshikian and Mohammad Reza Ghadir

Subjects
Medicine
Abstract

Introduction. Gastrinoma should be suspected when the peptic ulcer(s) is postbulbar, multiple, refractory, or recurrent, or ulcer is associated with nephrolithiasis, hypocalcaemia, or erosive esophagitis. The majority of gastrinomas are malignant. Case Presentation. The patient is a 41-year-old Iranian man who has been in good health until 36 months ago when duodenal perforation and two bouts of upper GI bleeding (GIB), each two months apart occurred. He also mentioned mild watery diarrhoea and decreased appetite. Serum gastrin level was elevated. Abdominal CT scan revealed pancreatic mass and three enhancing hepatic masses. CT-guided pancreatic biopsy revealed monotonous cells. Chemoembolization of hepatic metastases was done. New ct images 6 months later showed nearly total regressed hepatic and pancreatic lesions. Conclusion. Beside previously defined situations that take gastrinoma into account as the etiology of PUD, accumulation of PUD complications is highly suggestive of Zollinger-Ellisone syndrome (ZES). Regression of pancreatic primary after chemoembolization of hepatic metastases is unexplainable at the present time.

Published
2011
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3. Efficacy of Common Bile Duct Stenting on the Reduction in Gallstone Migration and Symptoms Recurrence in Patients with Biliary Pancreatitis Who Were Candidates for Delayed Cholecystectomy

Author

Gholam Reza Sivandzadeh, Mohsen Eshraghi, Amir Jabbari, Khosro Dehghan, Abolfazl Mohammadbeigi, Sajjad Ahmadpour, Seyed Saeid Sarkeshikian, Ahmad Hormati, Faezeh Alemi, and Mohammad Reza Ghadir

Subjects
medicine.medical_specialty, Common bile duct, Physiology, business.industry, medicine.medical_treatment, Gastroenterology, Stent, Gallstones, Hepatology, medicine.disease, Surgery, Clinical trial, 03 medical and health sciences, surgical procedures, operative, 0302 clinical medicine, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Internal medicine, medicine, Cholecystitis, Pancreatitis, 030211 gastroenterology & hepatology, Cholecystectomy, business
Abstract

In patients with severe biliary pancreatitis, delayed cholecystectomy associated with a high risk of recurrence is recommended. The current study aimed to evaluate the effect of common bile duct (CBD) stenting on reducing gallstones migration and recurrence of symptoms in patients with pancreatitis and delayed cholecystectomy candidates. To this purpose, the randomized, controlled clinical trial was performed on 40 patients with biliary pancreatitis who were candidates for delayed cholecystectomy. Patients were randomly divided into two groups of A and B that underwent CBD stenting after ERCP and received endoscopic treatment without stenting, respectively. A checklist recorded demographics and complications. Group A was followed up after four weeks to remove the stent and record the complications. Group B underwent MRCP to examine the migration of new gallstones as well as the complications. Of the 40 patients, 20 subjects (11 males and 9 females) were allocated to each group, matched for demographic variables. In the one-month follow-up, only one subject in group A manifested symptoms of gallstone migration and recurrence, while in group B, recurrence was observed in 6 patients (P = 0.037). There was no significant difference in the success rate of ERCP and the incidence of complications between the two groups. CBD stenting in patients with biliary pancreatitis and gallstone could reduce the risk of recurrence and remigration of gallstones in delayed cholecystectomy cases.

Published
2021
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4. Efficacy of Common Bile Duct Stenting on the Reduction in Gallstone Migration and Symptoms Recurrence in Patients with Biliary Pancreatitis Who Were Candidates for Delayed Cholecystectomy

Author

Ahmad, Hormati, Mohammad Reza, Ghadir, Faezeh, Alemi, Mohsen, Eshraghi, Khosro, Dehghan, Seyed Saeid, Sarkeshikian, Sajjad, Ahmadpour, Amir, Jabbari, Gholam Reza, Sivandzadeh, and Abolfazl, Mohammadbeigi

Subjects
Cholangiopancreatography, Endoscopic Retrograde, Male, Gallstones, Middle Aged, Article, Time-to-Treatment, Prosthesis Implantation, Postoperative Complications, Treatment Outcome, Pancreatitis, Secondary Prevention, Humans, Cholecystectomy, Female, Risk Adjustment, Stents
Abstract

In patients with severe biliary pancreatitis, delayed cholecystectomy associated with a high risk of recurrence is recommended. The current study aimed to evaluate the effect of common bile duct (CBD) stenting on reducing gallstones migration and recurrence of symptoms in patients with pancreatitis and delayed cholecystectomy candidates.To this purpose, the randomized, controlled clinical trial was performed on 40 patients with biliary pancreatitis who were candidates for delayed cholecystectomy. Patients were randomly divided into two groups of A and B that underwent CBD stenting after ERCP and received endoscopic treatment without stenting, respectively. A checklist recorded demographics and complications. Group A was followed up after four weeks to remove the stent and record the complications. Group B underwent MRCP to examine the migration of new gallstones as well as the complications.Of the 40 patients, 20 subjects (11 males and 9 females) were allocated to each group, matched for demographic variables. In the one-month follow-up, only one subject in group A manifested symptoms of gallstone migration and recurrence, while in group B, recurrence was observed in 6 patients (P = 0.037). There was no significant difference in the success rate of ERCP and the incidence of complications between the two groups.CBD stenting in patients with biliary pancreatitis and gallstone could reduce the risk of recurrence and remigration of gallstones in delayed cholecystectomy cases.

Published
2020

5. Large Inverted Colonic Diverticulum (LICD)

Author

Yousefi Mh, Ahmad Hormati, Seyed Saeid Sarkeshikian, Abolfazl Iranikhah, and Mohammad Reza Ghadir

Subjects
medicine.medical_specialty, business.industry, medicine, Radiology, Colonic Diverticulum, business
Published
2018
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6. Prevalence of Hepatitis D Virus Infection Among Hepatitis B Virus Infected Patients in Qom Province, Center of Iran

Author

Amir Hossein Ghanooni, Akram Heidari, Seyed Saeid Sarkeshikian, Maryam Vaez-javadi, Abolfazl Iranikhah, Mohammad Reza Ghadir, Mojtaba Belbasi, Seyed Moayed Alavian, and Alireza Kabiri

Subjects
medicine.medical_specialty, Pathology, HBsAg, viruses, Population, Iran, medicine.disease_cause, Internal medicine, medicine, Prevalence, education, Hepatitis B virus, education.field_of_study, Hepatology, Transmission (medicine), business.industry, Brief Report, virus diseases, Hepatitis B, medicine.disease, Hepatitis D, Kowsar, Infectious Diseases, Hepatitis D virus, business, Hepatitis B Virus
Abstract

Background Hepatitis D virus (HDV) is a defective RNA virus that depends on the hepatitis B surface antigen (HBsAg) of hepatitis B virus for its replication, developing exclusively in patients with acute or chronic hepatitis B. There are little data regarding the routes of HDV transmission in Iran. The risk factors for HDV infection in Iran are blood transfusion, surgery, family history, Hejamat wet cupping (traditional phlebotomy), tattooing, war injury, dental interventions, and endoscopy. Objectives We performed this study to determine the prevalence of hepatitis D in the general population of Qom province and the potential risk factors for acquiring HDV. Patients and methods This cross-sectional study collected 3690 samples from 7 rural clusters and 116 urban clusters. HBs antigen was measured, and if the test was positive, anti-HDV was measured. Ten teams, each consisting of 2 trained members, were assigned to conduct the sampling and administer the questionnaires. The data were analyzed using SPSS. Results Forty-eight subjects (1.3%) suffered from hepatitis B, and 1 HBsAg-positive case had HDV infection. The prevalence of hepatitis D infection in Qom Province was 0.03%. The prevalence of hepatitis D infection in HBsAg-positive cases was 2%. Our anti-HDV-positive case had a history of tattooing, surgery, and dental surgery. There was no significant relationship between tattooing, surgery history, or dental surgery and hepatitis D infection. Conclusions The prevalence of hepatitis D in Qom is the the lowest in Iran, similar to a study in Babol (north of Iran).

Published
2012

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