Pub Date : 2021-10-31DOI: 10.15279/kpba.2021.26.4.216
Inseok Lee
Pancreatic and biliary endoscopy certified doctors perform high-level procedures and try to improve public health by maintaining professionalism. In this manuscript, I review how the certification system is reflected in the Korean National Health Insurance. In addition, we considered the impact of certified pancreatic and biliary endoscopy doctors on the public. Through this, the pancreatobiliary endoscopy certification system is to be properly established and to contribute to the improvement of public health.
{"title":"Pancreatobiliary Endoscopy Certification System from the Perspective of Insurance Policy","authors":"Inseok Lee","doi":"10.15279/kpba.2021.26.4.216","DOIUrl":"https://doi.org/10.15279/kpba.2021.26.4.216","url":null,"abstract":"Pancreatic and biliary endoscopy certified doctors perform high-level procedures and try to improve public health by maintaining professionalism. In this manuscript, I review how the certification system is reflected in the Korean National Health Insurance. In addition, we considered the impact of certified pancreatic and biliary endoscopy doctors on the public. Through this, the pancreatobiliary endoscopy certification system is to be properly established and to contribute to the improvement of public health.","PeriodicalId":342618,"journal":{"name":"The Korean Journal of Pancreas and Biliary Tract","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127028771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-31DOI: 10.15279/kpba.2021.26.4.221
C. Park
It has been appealed to come up with the certificate system of pancreatobiliary endoscopist from summer endoscopic retrograde cholangiopancreatography camp in 2018. All members of Policy-Quality Management Board, Educational Board, and Insurance Affaires Board had the first workshop preparing for the certificate system of pancreatobiliary endoscopist on December 8, 2018. They discussed prerequisites to the certificate system of pancreatobiliary endoscopist as well as pros and cons on the system. After trying to prepare it over half year, a task force team (TFT) set sail for the certificate system of pancreatobiliary endoscopist. Throughout one workshop and five conferences, the TFT confirmed the official name of certificate system of pancreatobiliary endoscopist and made rules and regulations on the qualification of guidance medical specialists, training hospital qualifications, acquisition, maintenance and repair of certificate, and eligibility criteria for renewal.
{"title":"Summary of Task Force Team Work to Come up with Certificate System of Pancreatobiliary Endoscopist","authors":"C. Park","doi":"10.15279/kpba.2021.26.4.221","DOIUrl":"https://doi.org/10.15279/kpba.2021.26.4.221","url":null,"abstract":"It has been appealed to come up with the certificate system of pancreatobiliary endoscopist from summer endoscopic retrograde cholangiopancreatography camp in 2018. All members of Policy-Quality Management Board, Educational Board, and Insurance Affaires Board had the first workshop preparing for the certificate system of pancreatobiliary endoscopist on December 8, 2018. They discussed prerequisites to the certificate system of pancreatobiliary endoscopist as well as pros and cons on the system. After trying to prepare it over half year, a task force team (TFT) set sail for the certificate system of pancreatobiliary endoscopist. Throughout one workshop and five conferences, the TFT confirmed the official name of certificate system of pancreatobiliary endoscopist and made rules and regulations on the qualification of guidance medical specialists, training hospital qualifications, acquisition, maintenance and repair of certificate, and eligibility criteria for renewal.","PeriodicalId":342618,"journal":{"name":"The Korean Journal of Pancreas and Biliary Tract","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133044277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-31DOI: 10.15279/kpba.2021.26.4.254
J. Park
Bile acids are known to play a role in helping the digestion of lipid and maintenance of the bile flow. However, since the first bile acid receptor was discovered in 1999, it has been found that various bile acid receptors are present. Bile acid receptors are involved in bile acid physiology, energy metabolism, and inflammatory response. G-protein bile acid-activated receptor 1 (GPBAR1) and Sphingosine-1-phosphate receptor 2 (S1PR2) are representative bile acid receptors in cholangiocyte. They are involved in proliferation and secretion of cholangiocyte, which seem to protect cholangiocyte from the toxicity of bile acids. GPBAR1 and S1PR2 are also associated with the progression of cholangiocarcinoma.
{"title":"Bile Acid Receptors in Cholangiocyte","authors":"J. Park","doi":"10.15279/kpba.2021.26.4.254","DOIUrl":"https://doi.org/10.15279/kpba.2021.26.4.254","url":null,"abstract":"Bile acids are known to play a role in helping the digestion of lipid and maintenance of the bile flow. However, since the first bile acid receptor was discovered in 1999, it has been found that various bile acid receptors are present. Bile acid receptors are involved in bile acid physiology, energy metabolism, and inflammatory response. G-protein bile acid-activated receptor 1 (GPBAR1) and Sphingosine-1-phosphate receptor 2 (S1PR2) are representative bile acid receptors in cholangiocyte. They are involved in proliferation and secretion of cholangiocyte, which seem to protect cholangiocyte from the toxicity of bile acids. GPBAR1 and S1PR2 are also associated with the progression of cholangiocarcinoma.","PeriodicalId":342618,"journal":{"name":"The Korean Journal of Pancreas and Biliary Tract","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126313267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-31DOI: 10.15279/kpba.2021.26.4.211
K. Cho
The endoscopic retrograde cholangiopancreatography (ERCP) procedure requires concentration while wearing a heavy radiation protective suit and taking the risk of radiation exposure and complications. In order to successfully perform an ERCP procedure, it is necessary to understand the target disease, as well as appropriate education and training, and a certain amount of experience in the procedure. The Korean Pancreatobiliary Association organized a promotion committee to implement the “ERCP Certification” system to maintain education and quality control of ERCP procedures. A blueprint was prepared.
{"title":"Why Should We Implement a System of Endoscopic Retrograde Cholangiopancreatography Certification?","authors":"K. Cho","doi":"10.15279/kpba.2021.26.4.211","DOIUrl":"https://doi.org/10.15279/kpba.2021.26.4.211","url":null,"abstract":"The endoscopic retrograde cholangiopancreatography (ERCP) procedure requires concentration while wearing a heavy radiation protective suit and taking the risk of radiation exposure and complications. In order to successfully perform an ERCP procedure, it is necessary to understand the target disease, as well as appropriate education and training, and a certain amount of experience in the procedure. The Korean Pancreatobiliary Association organized a promotion committee to implement the “ERCP Certification” system to maintain education and quality control of ERCP procedures. A blueprint was prepared.","PeriodicalId":342618,"journal":{"name":"The Korean Journal of Pancreas and Biliary Tract","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130663907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-31DOI: 10.15279/kpba.2021.26.4.248
Gun Huh, T. Song
Endoscopic ultrasound (EUS)-guided transmural drainage of peripancreatic fluid collection, gallbladder, bile duct, or pancreatic duct has emerged as a therapeutic option in patients with pancreatobiliary diseases. Recently, dedicated stents for EUS-guided interventions, which include lumen-apposing metal stents and modified tubular self-expanding metal stents, have been developed to improve efficacy and safety of these procedures. This article has reviewed newly developed stents for EUSguided interventions and their therapeutic outcomes.
{"title":"New Stents for Endoscopic Ultrasound-Guided Procedures","authors":"Gun Huh, T. Song","doi":"10.15279/kpba.2021.26.4.248","DOIUrl":"https://doi.org/10.15279/kpba.2021.26.4.248","url":null,"abstract":"Endoscopic ultrasound (EUS)-guided transmural drainage of peripancreatic fluid collection, gallbladder, bile duct, or pancreatic duct has emerged as a therapeutic option in patients with pancreatobiliary diseases. Recently, dedicated stents for EUS-guided interventions, which include lumen-apposing metal stents and modified tubular self-expanding metal stents, have been developed to improve efficacy and safety of these procedures. This article has reviewed newly developed stents for EUSguided interventions and their therapeutic outcomes.","PeriodicalId":342618,"journal":{"name":"The Korean Journal of Pancreas and Biliary Tract","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128998087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-31DOI: 10.15279/kpba.2021.26.3.148
J. Choi, S. Lee
Post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP) is one of the most burdensome adverse events, occurs in about 3 to 15 percent of patients after the procedure. Various and extensive attempts have been made to find proper prophylaxis for PEP. Nowadays, pharmacologic agents consist one of the pivotal axis for prophylaxis for PEP. In this review article, we tried to overview pharmacologic prophylaxis including non-steroidal anti-inflammatory drugs, aggressive hydration, protease inhibitors, exocrine pancreatic secretion inhibitors, and nitrates from recent updated results of randomized controlled studies and key meta-analyses.
{"title":"Pharmachologic Prophylaxis for Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis","authors":"J. Choi, S. Lee","doi":"10.15279/kpba.2021.26.3.148","DOIUrl":"https://doi.org/10.15279/kpba.2021.26.3.148","url":null,"abstract":"Post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP) is one of the most burdensome adverse events, occurs in about 3 to 15 percent of patients after the procedure. Various and extensive attempts have been made to find proper prophylaxis for PEP. Nowadays, pharmacologic agents consist one of the pivotal axis for prophylaxis for PEP. In this review article, we tried to overview pharmacologic prophylaxis including non-steroidal anti-inflammatory drugs, aggressive hydration, protease inhibitors, exocrine pancreatic secretion inhibitors, and nitrates from recent updated results of randomized controlled studies and key meta-analyses.","PeriodicalId":342618,"journal":{"name":"The Korean Journal of Pancreas and Biliary Tract","volume":"118 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117283255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-31DOI: 10.15279/kpba.2021.26.3.181
C. Park
Traditionally, enteroscopy-guided endoscopic retrograde cholangiopancreatography (ERCP) was considered as troublesome procedure with high risk of complications in patients with surgically altered anatomy (SAA). However, recent studies have suggested that it might not have to be a foregone conclusion. In addition, various enteroscopes have been used for enteroscopy-guided ERCP in patients with SAA showing promising results. Among them, long type single balloon enteroscopes (SBE) have mostly been used for enteroscopy-guided ERCP in Korea. Recently, short type SBE can come in handy all around. Two major points should be considered when to choose between long type and short type SBE in SAA. First, it is the figurative difference between the two types of SBE that effects on actual results of enteroscopy-guided ERCP. Second, it is clinical studies using short type and/or long type SBE for enteroscopy-guided ERCP in patients with SAA. Conclusively speaking, short type SBE should be considered at first for enteroscopy-guided ERCP in most patients with SAA.
{"title":"Single Balloon Enteroscopy-Guided Endoscopic Retrograde Cholangiopancreatography in Surgically Altered Anatomy: Long vs. Short Type","authors":"C. Park","doi":"10.15279/kpba.2021.26.3.181","DOIUrl":"https://doi.org/10.15279/kpba.2021.26.3.181","url":null,"abstract":"Traditionally, enteroscopy-guided endoscopic retrograde cholangiopancreatography (ERCP) was considered as troublesome procedure with high risk of complications in patients with surgically altered anatomy (SAA). However, recent studies have suggested that it might not have to be a foregone conclusion. In addition, various enteroscopes have been used for enteroscopy-guided ERCP in patients with SAA showing promising results. Among them, long type single balloon enteroscopes (SBE) have mostly been used for enteroscopy-guided ERCP in Korea. Recently, short type SBE can come in handy all around. Two major points should be considered when to choose between long type and short type SBE in SAA. First, it is the figurative difference between the two types of SBE that effects on actual results of enteroscopy-guided ERCP. Second, it is clinical studies using short type and/or long type SBE for enteroscopy-guided ERCP in patients with SAA. Conclusively speaking, short type SBE should be considered at first for enteroscopy-guided ERCP in most patients with SAA.","PeriodicalId":342618,"journal":{"name":"The Korean Journal of Pancreas and Biliary Tract","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126954571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-31DOI: 10.15279/kpba.2021.26.3.195
J. Jang, J. H. Jun, Dong-kyu Lee, H. Kim, Y. Doh, I. Baek, S. Jung
Clip migration into the common bile duct (CBD) is a rare complication of laparoscopic biliary surgery. We report a case of Hem-o-lok clip migration-induced CBD stone in a 66-year-old man who underwent laparoscopic cholecystectomy (LC) and laparoscopic common bile duct exploration (LCBDE) 4 years ago. The patient visited the emergency room for upper abdominal pain. CT scan revealed increased CBD diameter and multiple CBD stones. We performed endoscopic retrograde cholangiopancreatography for CBD stone extraction. Cholangiography revealed multiple suspected filling defects in the CBD; stones and unknown foreign body were removed using Basket. The foreign body found in the duodenum was a Hem-o-lok clip. When epigastric pain develops in a patient who has undergone LC and LCBDE, it is possible that biliary stone occurs due to clip migration.
{"title":"Recurrent Cholangitis due to Hem-o-lok Clip Migration after Laparoscopic Common Bile Duct Exploration Treated with Endoscopic Retrograde Cholangiopancreatography","authors":"J. Jang, J. H. Jun, Dong-kyu Lee, H. Kim, Y. Doh, I. Baek, S. Jung","doi":"10.15279/kpba.2021.26.3.195","DOIUrl":"https://doi.org/10.15279/kpba.2021.26.3.195","url":null,"abstract":"Clip migration into the common bile duct (CBD) is a rare complication of laparoscopic biliary surgery. We report a case of Hem-o-lok clip migration-induced CBD stone in a 66-year-old man who underwent laparoscopic cholecystectomy (LC) and laparoscopic common bile duct exploration (LCBDE) 4 years ago. The patient visited the emergency room for upper abdominal pain. CT scan revealed increased CBD diameter and multiple CBD stones. We performed endoscopic retrograde cholangiopancreatography for CBD stone extraction. Cholangiography revealed multiple suspected filling defects in the CBD; stones and unknown foreign body were removed using Basket. The foreign body found in the duodenum was a Hem-o-lok clip. When epigastric pain develops in a patient who has undergone LC and LCBDE, it is possible that biliary stone occurs due to clip migration.","PeriodicalId":342618,"journal":{"name":"The Korean Journal of Pancreas and Biliary Tract","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126111218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-31DOI: 10.15279/kpba.2021.26.3.205
M. Yang, J. Hwang, B. Yoo, J. Kim
{"title":"Balloon Enteroscopy-Assisted Endoscopic Retrograde Cholangiopancreatography","authors":"M. Yang, J. Hwang, B. Yoo, J. Kim","doi":"10.15279/kpba.2021.26.3.205","DOIUrl":"https://doi.org/10.15279/kpba.2021.26.3.205","url":null,"abstract":"","PeriodicalId":342618,"journal":{"name":"The Korean Journal of Pancreas and Biliary Tract","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125069028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-31DOI: 10.15279/kpba.2021.26.3.176
Hoonsub So, H. Lee, T. Song
Acute pancreatitis is a sudden inflammatory disease that could be developed into a fatal condition. Traditional dogma was to rest the pancreas by fasting. However, evidence shows the benefits of early enteral feeding resulting in a shorter hospital stay, improved mortality, multi-organ failure, systemic infections, and the need for operative interventions. Clinicians should encourage enteral feeding as soon as possible even in severe acute pancreatitis if there are no contraindications. An immediate solid diet could be attempted. Regarding tube feeding, the nasojejunal tube did not show superiority to the nasogastric tube. Different formulas and probiotics need more investigation. Guidelines are against using prophylactic antibiotics, but Korean centers still report overuse of antibiotics. However, there is still a debate about using prophylactic antibiotics in severe acute pancreatitis. Broad-spectrum antibiotics should be initiated when an infection is suspected. In conclusion, enteral nutritional support and optimal use of antibiotics are the keys to the management of acute pancreatitis.
{"title":"Nutrition and Antibiotics for Acute Pancreatitis","authors":"Hoonsub So, H. Lee, T. Song","doi":"10.15279/kpba.2021.26.3.176","DOIUrl":"https://doi.org/10.15279/kpba.2021.26.3.176","url":null,"abstract":"Acute pancreatitis is a sudden inflammatory disease that could be developed into a fatal condition. Traditional dogma was to rest the pancreas by fasting. However, evidence shows the benefits of early enteral feeding resulting in a shorter hospital stay, improved mortality, multi-organ failure, systemic infections, and the need for operative interventions. Clinicians should encourage enteral feeding as soon as possible even in severe acute pancreatitis if there are no contraindications. An immediate solid diet could be attempted. Regarding tube feeding, the nasojejunal tube did not show superiority to the nasogastric tube. Different formulas and probiotics need more investigation. Guidelines are against using prophylactic antibiotics, but Korean centers still report overuse of antibiotics. However, there is still a debate about using prophylactic antibiotics in severe acute pancreatitis. Broad-spectrum antibiotics should be initiated when an infection is suspected. In conclusion, enteral nutritional support and optimal use of antibiotics are the keys to the management of acute pancreatitis.","PeriodicalId":342618,"journal":{"name":"The Korean Journal of Pancreas and Biliary Tract","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131959600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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