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A Review of Prevention of Post-ERCP Pancreatitis.
Gastroenterol Hepatol (N Y). 2018 May; 14(5):286-292.GH

Abstract

Endoscopic retrograde cholangiopancreatography (ERCP) is a diagnostic and therapeutic procedure employed in the management of disorders of the biliary system. Post-ERCP pancreatitis (PEP) is the most common complication of ERCP and can lead to significant morbidity as well as occasional mortality. In addition to adequate procedural training, therapeutic endoscopists who perform ERCPs should possess a thorough understanding of patient- and procedure-related risk factors for PEP. This knowledge can inform patient selection for ERCP and allow for appropriate management efforts to be performed in high-risk cases. Procedural techniques promoting minimally traumatic biliary cannulation should be employed when initial standard techniques are unsuccessful. In high-risk patients, several measures can be undertaken to limit the risk of PEP, including administration of rectal nonsteroidal anti-inflammatory drugs, prophylactic placement of pancreatic duct stents, and liberal administration of lactated Ringer solution. When PEP does occur, appropriate management with aggressive intravenous hydration, pain control, and early enteral nutrition should be administered. Additional research is needed to further define risk factors for PEP, optimal procedural techniques used during ERCP, and ideal prevention and treatment strategies to limit the incidence and severity of PEP in patients.

Authors+Show Affiliations

Dr Morales is a gastroenterology fellow, Dr Sampath is an advanced endoscopy fellow, and Dr Gardner is an associate professor of medicine in the Division of Gastroenterology at Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire.Dr Morales is a gastroenterology fellow, Dr Sampath is an advanced endoscopy fellow, and Dr Gardner is an associate professor of medicine in the Division of Gastroenterology at Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire.Dr Morales is a gastroenterology fellow, Dr Sampath is an advanced endoscopy fellow, and Dr Gardner is an associate professor of medicine in the Division of Gastroenterology at Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29991936

Citation

Morales, Shannon J., et al. "A Review of Prevention of Post-ERCP Pancreatitis." Gastroenterology & Hepatology, vol. 14, no. 5, 2018, pp. 286-292.
Morales SJ, Sampath K, Gardner TB. A Review of Prevention of Post-ERCP Pancreatitis. Gastroenterology & hepatology. 2018;14(5):286-292.
Morales, S. J., Sampath, K., & Gardner, T. B. (2018). A Review of Prevention of Post-ERCP Pancreatitis. Gastroenterology & Hepatology, 14(5), 286-292.
Morales SJ, Sampath K, Gardner TB. A Review of Prevention of Post-ERCP Pancreatitis. Gastroenterology & hepatology. 2018;14(5):286-292. PubMed PMID: 29991936.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A Review of Prevention of Post-ERCP Pancreatitis. AU - Morales,Shannon J, AU - Sampath,Kartik, AU - Gardner,Timothy B, PY - 2018/7/12/entrez PY - 2018/7/12/pubmed PY - 2018/7/12/medline KW - Post-endoscopic retrograde cholangiopancreatography pancreatitis KW - lactated Ringer solution KW - prophylactic pancreatic stent placement KW - rectal nonsteroidal anti-inflammatory drugs SP - 286 EP - 292 JF - Gastroenterology & hepatology VL - 14 IS - 5 N2 - Endoscopic retrograde cholangiopancreatography (ERCP) is a diagnostic and therapeutic procedure employed in the management of disorders of the biliary system. Post-ERCP pancreatitis (PEP) is the most common complication of ERCP and can lead to significant morbidity as well as occasional mortality. In addition to adequate procedural training, therapeutic endoscopists who perform ERCPs should possess a thorough understanding of patient- and procedure-related risk factors for PEP. This knowledge can inform patient selection for ERCP and allow for appropriate management efforts to be performed in high-risk cases. Procedural techniques promoting minimally traumatic biliary cannulation should be employed when initial standard techniques are unsuccessful. In high-risk patients, several measures can be undertaken to limit the risk of PEP, including administration of rectal nonsteroidal anti-inflammatory drugs, prophylactic placement of pancreatic duct stents, and liberal administration of lactated Ringer solution. When PEP does occur, appropriate management with aggressive intravenous hydration, pain control, and early enteral nutrition should be administered. Additional research is needed to further define risk factors for PEP, optimal procedural techniques used during ERCP, and ideal prevention and treatment strategies to limit the incidence and severity of PEP in patients. SN - 1554-7914 UR - https://www.unboundmedicine.com/medline/citation/29991936/A_Review_of_Prevention_of_Post_ERCP_Pancreatitis_ L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/29991936/ DB - PRIME DP - Unbound Medicine ER -
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