内镜逆行胰胆管造影术（ERCP）相关不良事件：ERCP术后胰腺炎
Endoscopic retrograde cholangiopancreatography (ERCP)-related adverse events: post-ERCP pancreatitis.
作者信息
Rustagi Tarun, Jamidar Priya A
机构信息
Section of Digestive Diseases, Department of Internal Medicine, Yale University School of Medicine, 333 Cedar Street, 1080 LMP, New Haven, CT 06520, USA.
Section of Digestive Diseases, Department of Internal Medicine, Yale University School of Medicine, 333 Cedar Street, 1080 LMP, New Haven, CT 06520, USA.
出版信息
Gastrointest Endosc Clin N Am. 2015 Jan;25(1):107-21. doi: 10.1016/j.giec.2014.09.006.
Post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP) is the most common complication of endoscopic retrograde cholangiopancreatography (ERCP), and not uncommonly is the reason behind ERCP-related lawsuits. Patients at high risk for PEP include young women with abdominal pain, normal liver tests, and unremarkable imaging. Procedure-related factors include traumatic and persistent cannulation attempts, multiple injections of the pancreatic duct, pancreatic sphincterotomy, and, possibly, use of precut sphincterotomy. Aggressive hydration, use of rectal indomethacin, and prophylactic pancreatic stenting can diminish the risk (and likely severity) of PEP. Though hugely beneficial, these measures do not supersede careful patient selection and technique.
内镜逆行胰胆管造影术后胰腺炎（PEP）是内镜逆行胰胆管造影术（ERCP）最常见的并发症，也是ERCP相关诉讼的常见原因。PEP高危患者包括有腹痛、肝功能检查正常且影像学检查无异常的年轻女性。与操作相关的因素包括创伤性和持续性插管尝试、多次胰管注射、胰括约肌切开术，以及可能使用的预切开括约肌切开术。积极补液、使用直肠吲哚美辛和预防性胰管支架置入可降低PEP的风险（以及可能的严重程度）。尽管这些措施非常有益，但并不能取代仔细的患者选择和技术操作。
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