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Merete Christensen

Publications and source records attributed to Merete Christensen.

5 recordsLinked to original sources
PubMed2005

ECG changes during endoscopic retrograde cholangio-pancreatography and coronary artery disease.

OBJECTIVE: Myocardial ischaemia has been described during endoscopic retrograde cholangio-pancreatography (ERCP), but the pathogenesis remains unclear. The aim of the present study was to evaluate whether coronary artery disease was present in patients with ST-segment changes during ERCP. MATERIAL AND METHODS: Forty patients were monitored with a Holter tape recorder during ERCP. Patients with ST-segment deviation during ERCP subsequently underwent a standard exercise ECG test. RESULTS: Twelve patients developed signs of myocardial ischaemia during ERCP (30%) and 9 had concomitant tachycardia. None had a cardiac history or cardiorespiratory symptoms. Ten of the 12 patients did an exercise test and one patient developed silent ischaemia. Subsequent coronary angiography showed no evidence of coronary artery disease. CONCLUSIONS: No signs of existing coronary artery disease were found in patients developing ST deviation during ERCP when evaluated with a 12-lead exercise ECG test. Further studies should evaluate other mechanisms responsible for myocardial ischaemia during ERCP.

Adult↗
PubMed2004

Complications of ERCP: a prospective study.

BACKGROUND: Studies of ERCP-related morbidity seldom include a sufficient patient follow-up. The aim of this study was to characterize and to evaluate the frequency of complications, cardiopulmonary untoward events in particular. METHODS: All patients undergoing ERCP during a 2-year period were included in this prospective study. Complications were assessed at the time of ERCP and by postal/telephone contact at 30-days after the procedure. RESULTS: A total of 1177 ERCPs were included in the analysis, of which 56.2% were therapeutic. The 30-day complication rate was 15.9%; the procedure-related mortality rate was 1.0%. Post-ERCP pancreatitis occurred in 3.8% of patients (3 deaths). Hemorrhage or perforation occurred with 0.9% and 1.1%, respectively, of the procedures (3 deaths). One perforation that resulted in the death of the patient occurred after placement of an endoprosthesis. Cholangitis occurred in relation to 5% of the ERCP procedures (3 deaths). Cardiorespiratory complications occurred in 2.3% (2 deaths). Dilated bile duct ( p = 0.0001), placement of stent ( p = 0.001), and use of more than 40 mg of hyoscine-N-butyl bromide ( p < 0.05) were risk factors for complications by multivariate analysis. Risk of pancreatitis was increased with age under 40 years ( p = 0.0078), placement of stent ( p = 0.031), and a dilated bile duct ( p = 0.036). CONCLUSIONS: This prospective study confirms that the complication rate of ERCP including therapeutic procedures is high. Cardiopulmonary complications were not as common as expected, despite being the special focus of the study.

Adolescent↗
PubMed2003

[The value of using fluoroscopy during colonoscopy. A prospective randomized study].

INTRODUCTION: No randomised trials have estimated the value of using fluoroscopy for colonoscopy. The aim of our study was to estimate the rate of success using this method. MATERIAL AND METHODS: In a prospective trial 264 patients were included, 139 were examined without fluoroscopy-equipment (Group A), and 125 with fluoroscopy-equipment (Group B). We registered: Indication for colonoscopy, duration of the colonoscopy, medication, time in which X-ray was being used, whether coecum was reached or not, clinical results of the examinations and complications. In cases where coecum was not intubated the cause was registered. RESULTS: We found a significantly higher rate of success of the colonoscopy in Group B (84%) than in group A (74%) (p = 0.045). Pain and looping of the scope were the main reasons for insufficient examination. DISCUSSION: In a modern endoscopic ward fluoroscopy must be available, but it seems reasonable to start uncomplicated colonoscopies without the use of fluoroscopy. In cases where coecal intubation is not obtained, conversion to examination with fluoroscopy should be possible.

Adult↗
PubMed2002

Factors that affect the variability in heart rate during endoscopic retrograde cholangiopancreatography.

OBJECTIVE: To find out if drugs, position, and endoscopic manipulation during endoscopic retrograde cholangiopancreatography (ERCP) influence the changes in the variability of heart rate. DESIGN: Single-blind randomised trial. SUBJECTS: 10 volunteers given butyscopolamine, glucagon, or saline intravenously on three different study days, and 10 patients who had ERCP without butylscopolamine or glucagon. MAIN OUTCOME MEASURES: Holter tape analysis for ischaemia and changes in the variability of heart rate. RESULTS: 5 volunteers developed tachycardia after butylscopolamine, while 2 developed tachycardia after glucagon. During ERCP 9 patients developed tachycardia, and 2 developed myocardial ischaemia. Vagal tone decreased in the volunteers after butylscopolamine, but no changes were seen after glucagon or placebo, or in patients during ERCP. CONCLUSIONS: Butylscopolamine reduced vagal tone in volunteers. Patients who were having ERCP without butylscopolamine had a stable vagal tone. The previously observed reduced vagal tone during ERCP may therefore be primarily the result of giving butylscopolamine.

Adult↗