PANCREATOLOGY 

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

Copyright © 2014 EDIZIONI MINERVA MEDICA

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.