Early successes and late failures in the prevention of post endoscopic retrograde cholangiopancreatography.

Abstract

Acute pancreatitis is the most common complication of endoscopic retrograde cholangiopancreatography (ERCP). The only way to prevent this complication is to avoid an ERCP all together. Because of the risks involved, a careful consideration should be given to the indication for ERCP and the potential risk/benefit ratio of the test. Once a decision to perform an ERCP is made, the procedure should be carried out with meticulous care by an experienced endoscopist, and with a minimum of pancreatic duct opacification. Several pharmacologic agents have been tested, but to date the most important method of reducing post ERCP pancreatitis is the placement of pancreatic stent. Pancreatic stents should be placed in all patients at high risk of this complication such as those undergoing pancreatic sphincterotomy, pancreatic duct manipulation and intervention, and patients with suspected sphincter of Oddi dysfunction. Pancreatic stents should be also considered in patients requiring precut sphincterotomy to gain biliary access.

• Authors: John G Lieb 2nd, Peter V Draganov
• Journal: World journal of gastroenterology (World J Gastroenterol) Vol. 13 Issue 26 Pg. 3567-74 (Jul 14 2007) ISSN: 1007-9327 [Print] United States
• PMID: 17659706 (Publication Type: Journal Article, Review)

Chemical References

• Anti-Inflammatory Agents
• Antioxidants
• Serine Proteinase Inhibitors
• Interleukin-10
• Gabexate
• Somatostatin

Topics

• Acute Disease
• Animals
• Anti-Inflammatory Agents (therapeutic use)
• Antioxidants (therapeutic use)
• Cholangiopancreatography, Endoscopic Retrograde
• Gabexate (therapeutic use)
• Humans
• Interleukin-10 (therapeutic use)
• Pancreas
• Pancreatitis (prevention & control)
• Postoperative Complications (prevention & control)
• Serine Proteinase Inhibitors (therapeutic use)
• Somatostatin (therapeutic use)
• Stents