The Peter B. Cotton Endowed Chair in Endoscopic Innovation, Division of Gastroenterology & Hepatology, Medical University of South Carolina, Charleston, USA.
Dig Endosc. 2017 Nov;29(7):749-757. doi: 10.1111/den.12908. Epub 2017 Jul 19.
Pancreatitis is the most common and potentially devastating complication of endoscopic retrograde cholangiopancreatography (ERCP), resulting in significant morbidity, occasional mortality, and increased health-care expenditure. Accordingly, the prevention of post-ERCP pancreatitis (PEP) remains a major clinical and research priority. Strategies to reduce the incidence of PEP include thoughtful patient selection, appropriate risk-stratification, sound procedural technique, prophylactic pancreatic stent placement, and pharmacoprevention. Despite advances in all these areas, however, the incidence of PEP remains as high as 15% in high-risk cases. Thus, additional research towards the goal of eliminating PEP is necessary. Herein is an evidence-based review of strategies to prevent pancreatitis after ERCP, focusing on recent important developments in the field.
胰腺炎是内镜逆行胰胆管造影（ERCP）最常见且潜在的严重并发症，可导致较高的发病率、偶尔的死亡率和增加医疗保健支出。因此，预防 ERCP 后胰腺炎（PEP）仍然是一个主要的临床和研究重点。降低 PEP 发生率的策略包括仔细选择患者、适当的风险分层、合理的操作技术、预防性胰管支架置入和药物预防。然而，尽管在所有这些方面都取得了进展，高危病例的 PEP 发生率仍高达 15%。因此，有必要针对消除 PEP 的目标进行更多的研究。本文是一篇针对 ERCP 后预防胰腺炎的策略的循证综述，重点介绍了该领域的最新重要进展。
