RESUMEN
Complications that may occur after an endoscopic retrograde cholangiopancreatography (ERCP) procedure include pancreatitis, bleeding, cholangitis, cholecystis, perforation, and post-ERCP pancreatitis (PEP). Of these, PEP is the most common complication and 10% of patients can die from severe pancreatitis. Prevention of PEP requires the selection of an appropriate patient group according to their ERCP indications and a full awareness of the risk factors. The incidence rate can be reduced to some extent through medication and ERCP manipulation changes. The use of a spile through the guidewire during ERCP manipulation and temporary pancreatic duct stent insertion can be effective, and the administration of suppository NSAIDs as medication reduces the occurrence of PEP. Drugs such as glyceryl trinitrate (GTN), nafamostat, and somatostatin can be considered as the second best treatment in the cases where NSAIDs are contraindicated or where a plastic catheter cannot be inserted or fails after insertion into the pancreatic duct.
Asunto(s)
Humanos , Antiinflamatorios no Esteroideos , Catéteres , Colangiopancreatografia Retrógrada Endoscópica , Colangitis , Hemorragia , Incidencia , Nitroglicerina , Conductos Pancreáticos , Pancreatitis , Plásticos , Factores de Riesgo , Somatostatina , StentsRESUMEN
ERCP has become an important method for diagnosis and treatment of digestive diseases, but the high incidences of post-ERCP complications (PEP), especially for post-ERCP pancreatitis, have limited its application. Prevention of PEP has become a focus of ERCP-related studies. Current drug prevention of PEP is not satisfactory, and there has not been a single drug which can effectively prevent PEP. In contrast, non-pharmacologic preventive techniques such as pancreatic stent placing and guide wire cannulation have been proven to have prominent effects in preventing PEP, which brings new hopes for PEP prevention. This paper reviews the studies on non-pharmacologic prevention of PEP.
RESUMEN
ERCP has become an important method for diagnosis and treatment of digestive diseases,but the high incidences of post-ERCP complications(PEP),especially for post-ERCP pancreatitis,have limited its application.Prevention of PEP has become a focus of ERCP-related studies.Current drug prevention of PEP is not satisfactory,and there has not been a single drug which can effectively prevent PEP.In contrast,non-pharmacologic preventive techniques such as pancreatic stent placing and guide wire cannulation have been proven to have prominent effects in preventing PEP,which brings new hopes for PEP prevention.This paper reviews the studies on non-pharmacologic prevention of PEP.