Northwestern Medicine, Chicago, Illinois, USA.
Am J Gastroenterol. 2020 Apr;115(4):535-536. doi: 10.14309/ajg.0000000000000553.
Post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP) remains a common and potentially severe adverse event, with continued research efforts to reduce PEP incidence. Robust evidence exists supporting the selective use of pancreatic duct stent placement, administration of rectal indomethacin, wire-guided cannulation technique, and aggressive fluid hydration using lactated Ringer solution. Jang et al. presented a randomized control trial describing primary needle-knife fistulotomy and its benefit for biliary access and reduced PEP incidence. Although these data are compelling, we discuss the key study limitations and the need for further studying the role of primary needle-knife fistulotomy.
经内镜逆行胰胆管造影术后胰腺炎（PEP）仍然是一种常见且潜在严重的不良事件，目前仍在继续研究降低 PEP 发生率的方法。有大量证据支持选择性使用胰管支架置入、直肠吲哚美辛给药、导丝引导插管技术和使用乳酸林格溶液进行积极的液体水化。Jang 等人提出了一项随机对照试验，描述了主针刀窦道切开术及其对胆道入路的益处和降低 PEP 发生率的作用。尽管这些数据很有说服力，但我们讨论了关键的研究局限性和进一步研究主针刀窦道切开术作用的必要性。
