Post-endoscopic retrograde cholangio-pancreatography pancreatitis:Is time for a new preventive approach?

作     者：Stella Tammaro Roberta Caruso Francesco Pallone Giovanni Monteleone 

作者机构：Division of GastroenterologyAzienda Ospedaliera Universitaria84131 SalernoItaly Department of Systems MedicineDivision of GastroenterologyUniversity of Rome Tor Vergata00133 RomeItaly 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2012年第18卷第34期

页      面：4635-4638页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

基　　金：Supported by The Fondazione "Umberto Di Mario" Onlus Rome 

主　　题：Endoscopic retrograde cholangiopancrea-tography Post-endoscopic retrograde cholangiopancre-atography pancreatitis Non-steroidal anti-inflammatorydrugs Indomethacin Pancreatitis prevention 

摘      要：Acute pancreatitis is the most common serious complication of endoscopic retrograde cholangio-pancre-atography (ERCP) and its incidence may exceed 25% in some high-risk patient subsets. In some patients, pancreatitis may follow a severe course with pancreatic necrosis, multiorgan failure, permanent disability and even death. Hence, approaches which minimize both the incidence and severity of post-ERCP pancreatitis are worth pursuing. Pancreatic stents have been used with some success in the prevention of post-ERCP, while so far pharmacological trials have yielded disappointing results. A recent multicenter, randomized, placebo-controlled, double-blind trial has shown that rectally administered indomethacin is effective in reducing the incidence of post-ERCP pancreatitis, the occurrence of episodes of moderate-to-severe pancreatitis and the length of hospital stay in high-risk patients. These results together with the demonstration that rectal administration of indomethacin is not associated with en-hanced risk of bleeding strongly support the use of this drug in the prophylaxis of post-ERCP pancreatitis.