Prevention of Post–Endoscopic Retrograde Cholangiopancreatography Pancreatitis: Medications and Techniques

Over the past 2 decades, it increasingly has been recognized that endoscopic retrograde cholangiopancreatography (ERCP) is the most predictable provocateur of acute pancreatitis, with an incidence of more than 15% in high-risk patients. For this reason, there has been considerable interest in the ef...

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Published inClinical gastroenterology and hepatology Vol. 14; no. 11; pp. 1521 - 1532.e3
Main Authors Wang, Andrew Y, Strand, Daniel S, Shami, Vanessa M
Format Journal Article
LanguageEnglish
Published United States Elsevier Inc 01.11.2016
Subjects
Cholangiopancreatography, Endoscopic Retrograde - adverse effects
Cholangiopancreatography, Endoscopic Retrograde - methods
ERCP
Gastroenterology and Hepatology
Humans
Medications
Pancreatitis
Pancreatitis - prevention & control
Perioperative Care - methods
Prevention
Stents
NTG
RR
RCT
NSAID
odds ratio
guidewire
large papillary balloon dilation
Prevention
endoscopic retrograde cholangiopancreatography
intravenous
NNT
nitroglycerin
TPS
Medications
sphincter of Oddi dysfunction
Stents
needle knife
SS
CCC
OR
pancreatic duct
LPBD
CI
Pancreatitis
SOD
post–endoscopic retrograde cholangiopancreatography pancreatitis
IV
relative risk
randomized controlled trial
GW
catheter cannulation followed by contrast opacification
PD
somatostatin
number-needed-to-treat
ERCP
confidence interval
PEP
transpancreatic sphincterotomy or septotomy
NK
nonsteroidal anti-inflammatory drug
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Summary:Over the past 2 decades, it increasingly has been recognized that endoscopic retrograde cholangiopancreatography (ERCP) is the most predictable provocateur of acute pancreatitis, with an incidence of more than 15% in high-risk patients. For this reason, there has been considerable interest in the effect of periprocedural drug administration as well as different ERCP techniques on both the incidence and severity of post-ERCP pancreatitis. Although many agents and techniques have shown promise in small clinical studies, the majority of these have failed to yield consistent benefit in larger randomized patient groups. This review summarizes the data on medications and ERCP techniques that have been studied for the prevention of post-ERCP pancreatitis.
Bibliography:ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Feature-3
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ObjectType-Review-1
ISSN:1542-3565
1542-7714
DOI:10.1016/j.cgh.2016.05.026