Kowalski Michał, Przybyłkowski Adam
Department of Gastroenterology and Internal Medicine, Medical University of Warsaw, 02-097 Warsaw, Poland.
Diagnostics (Basel). 2024 Dec 13;14(24):2806. doi: 10.3390/diagnostics14242806.
Endoscopic retrograde cholangiopancreatography (ERCP) is a key therapeutic procedure in diseases of the pancreas or bile ducts. The understanding and effective management of the risks associated with the procedure, especially in the context of possible infectious complications, is crucial for patients' safety. The aim of this review was to analyze the results of studies on antibiotic prophylaxis for infectious complications of ERCP, pancreatoscopy, and cholangioscopy.
This study is a review of the articles available in PubMed, Medline, and Embase published in the last 30 years.
Nineteen studies and six sets of guidelines on antibiotic prophylaxis before ERCP were retrieved.
Based on the available studies and recommendations, it can be concluded that antibiotic prophylaxis before ERCP is beneficial for immunocompromised patients or those at risk of bacterial endocarditis. In other groups of patients, antibiotic prophylaxis reduces the risk post-ERCP bacteremia but does not significantly reduce the risk of cholangitis and infectious complications. The effectiveness of antibiotic prophylaxis in patients at risk of incomplete biliary drainage needs to be verified in further studies.
内镜逆行胰胆管造影术（ERCP）是胰腺或胆管疾病的关键治疗手段。了解并有效管理该手术相关风险，尤其是在可能出现感染性并发症的情况下，对患者安全至关重要。本综述的目的是分析关于ERCP、胰管镜检查和胆管镜检查感染性并发症抗生素预防的研究结果。
本研究是对过去30年在PubMed、Medline和Embase上发表的文章的综述。
检索到19项关于ERCP术前抗生素预防的研究和6套指南。
根据现有研究和建议，可以得出结论，ERCP术前抗生素预防对免疫功能低下患者或有细菌性心内膜炎风险的患者有益。在其他患者群体中，抗生素预防可降低ERCP术后菌血症风险，但不能显著降低胆管炎和感染性并发症的风险。有胆管引流不完全风险患者的抗生素预防效果需要进一步研究验证。
