Prevention of post ERCP pancreatitis:An overview

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2008 (EN)
Prevention of post ERCP pancreatitis:An overview (EN)

Katsinelos, P.
Lazaraki, Georgia.

Therapeutic ERCP has become an accepted interventional method for both biliary and pancreatic diseases despite complications. Post-ERCP pancreatitis, a complication associated to the technique and the endoscopist’s skills, remains a burning issue since it has been reported to occur in 2-9% in unselected prospective series, and up to 30% in some series due to diverse definitions of post-ERCP pancreatitis and different methods of data collection. The severity of post-ERCP pancreatitis can range from a minor inconvenience, to a devastating illness (0.3% to 0.6% in prospective series) with pancreatic necrosis, multiorgan failure, permanent disability, and even death. Patient-related risk factors (i.e. patient indication selection, young age, sphincter of Oddi dysfunction, female sex, previous pancreatitis, potentially pancreatotoxic drugs, anatomic variations) and endoscopy-related factors (precut sphincterotomy, injection of contrast media into the pancreatic duct, difficulty of cannulation), have all been reported to increase the risk of developing post-ERCP pancreatitis. Pharmacological agents, such as nifedipine, glucagon, calcitonin, n-acetylcysteine, allopurinol, corticosteroids, low-molecular weight heparin, gabexate, somatostatin and its analogues, have been proposed with the indication of avoiding post-ERCP pancreatitis. Novelties in cannulation techniques and improved equipment, along with specific endoscopic interventions, as prophylactic pancreatic stent placement, have also been proposed to effectively reduce the risk. This review provides an evidence- based assessment of published data on prevention of post-ERCP pancreatitis and current suggestions for its avoidance. (EN)

Ελληνική Γαστροεντερολογική Εταιρία (EL)
Hellenic Gastroenterologiki Company (EN)

2008-07-10


Annals of Gastroenterology (EN)

Annals of Gastroenterology; Volume 21, No 1 (2008); 27-38 (EN)



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