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A Journal on Internal Medicine

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Minerva Medica 2014 April;105(2):129-36

language: English

Prevention of post-ERCP pancreatitis

Baron T. H. 1, Irani S. 2

1 Division of Gastroenterology and Hepatology University of North Carolina, Chapel Hill, NC, USA;
2 Department of Gastroenterology Virginia Mason Medical Center, Seattle, WA, USA


Over the last 10-15 years there have been refinements in the understanding of risk factors for development of acute post-ERCP pancreatitis (PEP). These risk factors can be divided into patient risks and procedural risks. The most basic way to prevent PEP is avoidance of purely diagnostic ERCP and low-probability ERCP for bile duct stones by use of non-invasive or less-invasive imaging procedures. Improvement in cannulation techniques has led to a reduction in PEP. Placement of prophylactic pancreatic stents and, more recently, use of rectally administered non-steroidal anti-inflammatory agents (NSAIDs) has further reduced the risk of PEP in high-risk patients and/or following high-risk procedures. In this review the methods for prevention of PEP will be discussed.

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