Delayed Onset Post-ERCP Pancreatitis (DOPE-P)
DOI:
https://doi.org/10.17140/POJ-2-e008Keywords:
pancreatic sphincterotomy, endoscopic papillary large-balloon dilatation of an intact sphincterAbstract
Post Endoscopic retrograde cholangiopancreatography (ERCP) Pancreatitis (PEP) is defined as new onset or worsening of pain abdomen after ERCP with an elevation of pancreatic en-zymes (amylase/lipase) more than 3 times upper limit of normal after 24 hours of procedure and prolongation of hospital stay/planned admission.1,2,3 The overall incidence of PEP is estimated to be 3-10%.1,2,3 Various risk factors found in multivariate trials are divided into patient-related risk factor (prior PEP, female sex, young patient, normal bilirubin, previous recurrent pancreatitis, suspected sphincter of Oddi dysfunction, absence of chronic pan-creatitis) and procedure-related risk factors (difficult cannulation i.e. >10 minutes cannulation time, repetitive pancreatic duct guide wire cannulation, pancreatic duct contrast injection, pancreatic sphincterotomy, endoscopic papillary large-balloon dilatation of an intact sphincter). Placement of prophylactic pancreatic stents (PPSs) usually advocated in high-risk patients and reduced PEP rate by 60-80%.4,5 3 Fr stents have higher migration rate and hence 5 Fr stents are superior to 3 Fr. Studies have shown that if place-ment of pancreatic stent is attempted but fails risk of PEP in-creases.
References
Dumonceau JM, Andriulli A, Elmunzer BJ, et al. Prophylaxis of post-ERCP pancreatitis: European society of gastrointestinal endoscopy (esge) guideline - updated june 2014. Endoscopy. 2014; 46(9): 799-815. doi: 10.1055/s-0034-1377875
ASGE Standards of Practice Committee, Anderson MA, Fisher L, Jain R, et al. Complications of ERCP. Gastrointest Endosc. 2012; 75(3): 467-73. doi: 10.1016/j.gie.2011.07.010
ASGE Standards of Practice Committee, Chandrasekhara V, Khashab MA, Muthusamy VR, et al. Adverse events associated with ERCP. Gastrointest Endosc. 2017; 85(1): 32-47. doi: 10.1016/j. gie.2016.06.051
Mazaki T, Masuda H, Takayama T. Prophylactic pancreatic stent place- ment and post-ERCP pancreatitis: A systematic review and meta-analysis. Endoscopy. 2010; 42: 842-853. doi: 10.1055/s-0030- 1255781
Choudhary A, Bechtold ML, Arif M, et al. Pancreatic stents-for prophylaxis against post-ERCP pancreatitis: A meta-analysis and systematic review. Gastrointest Endosc. 2011; 73: 275-282. doi: e8 Pancreas Open J. 2018; 2(1): e8-e9. doi: 10.17140/POJ-2-e008 10.1016/j.gie.2010.10.039
Choksi NS, Fogel EL, Cote GA, et al. The risk of post-ERCP pancreatitis and the protective effect of rectal indomethacin in cases of attempted but unsuccessful prophylactic pancreatic stent placement. Gastrointest Endosc. 2015; 81(1): 150-155. doi: 10.1016/j. gie.2014.07.033 Submit your article to this journal | https://openventio.org/submit-manuscript/ e9 Khurana V PUBLISHERS
Freeman ML. Use of Prophylactic Pancreatic Stents for the Prevention of Post-ERCP Pancreatitis. Gastroenterol Hepatol (N Y). 2015; 11(6): 420-422.
Moffatt DC, Coté GA, Fogel EL, et al. Acute pancreatitis after removal of retained prophylactic pancreatic stents. Gastrointest En-dosc. 2011; 73(5): 980-986. doi: 10.1016/j.gie.2011.01.012 Editorial | Volume 2 | Number 1|
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
All content published in Pancreas (POJ) is licensed under the Creative Commons Attribution 4.0 International License (CC BY 4.0). This license allows anyone to copy, distribute, transmit, and adapt the work — including for commercial purposes — provided appropriate credit is given to the original author(s) and source.