alexa Post-ERCP Pancreatitis: Mechanisms, Risk Factors, and Prevention | OMICS International
ISSN: 2165-7092

Pancreatic Disorders & Therapy
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Review Article

Post-ERCP Pancreatitis: Mechanisms, Risk Factors, and Prevention

Majed El Zouhairi, David Swartz and Tilak Shah*
Division of Gastroenterology, Duke University Medical Center, Durham, NC, USA
Corresponding Author : Tilak Shah
Duke University Medical Center Durham
NC, USA, 27710
Tel: 919-286-2287
Fax: 919-613-6352
E-mail: [email protected]
Received April 05, 2013; Accepted May 29, 2013; Published June 02, 2013
Citation: Zouhairi ME, Swartz D, Shah T (2013) Post-ERCP Pancreatitis: Mechanisms, Risk Factors, and Prevention. Pancreatic Dis Ther 3:116. doi:10.4172/2165-7092.1000116
Copyright: © 2013 Zouhairi ME, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Acute pancreatitis is the most common complication of endoscopic retrograde cholangiopancreatography (ERCP), occurring in up to 30 to 40% of high risk patients. The most prominent theories of post-ERCP pancreatitis (PEP) pathogenesis include mechanical trauma to the papillary orifice, hydrostatic injury, and enzymatic injury from activated proteolytic enzymes introduced from the duodenum. Investigators have proposed a number of patient-related, procedure-related, and physician-related risk factors for PEP. However, when evaluated in large prospective trials, the role of these factors in increasing risk of PEP is inconsistent. Placement of a pancreatic duct stent and administration of rectal non-steroidal anti-inflammatory drugs (NSAIDs) are the two interventions with the greatest body of evidence supporting efficacy in PEP prevention.

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