Emerging Therapies to Prevent Post-ERCP Pancreatitis

Purpose of Review The aim of this review is to evaluate emerging, novel therapies for the prevention of post-ERCP pancreatitis. Recent Findings Rectal indomethacin reduces the risk of pancreatitis in low- and average-risk patients, who comprise the majority of patients undergoing ERCP. An 8-h protoc...

Full description

Saved in:
Bibliographic Details
Published in:Current gastroenterology reports 2020-12, Vol.22 (12), p.59-59, Article 59
Main Authors: Thiruvengadam, Nikhil R., Kochman, Michael L.
Format: Article
Language:English
Subjects:
Abdomen
Cohort analysis
Cytokines
Edema
Endoscopy
Endoscopy and Surgery (S Komanduri
Enzymes
Gastroenterology
Inflammation
Medicine
Medicine & Public Health
Nonsteroidal anti-inflammatory drugs
Pancreas
Pancreatitis
Patients
Prevention
Risk factors
Section Editor
Topical Collection on Endoscopy and Surgery
Trauma
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Purpose of Review The aim of this review is to evaluate emerging, novel therapies for the prevention of post-ERCP pancreatitis. Recent Findings Rectal indomethacin reduces the risk of pancreatitis in low- and average-risk patients, who comprise the majority of patients undergoing ERCP. An 8-h protocol of aggressive lactated Ringer’s reduces the risk of pancreatitis in average-risk patients. Sublingual nitrate may provide additional benefit to rectal NSAIDs in preventing PEP. A tacrolimus trough > 2.5 ng/mL was recently shown to be associated with a lower risk of PEP in liver transplant patients undergoing ERCP. Summary Routine usage of rectal indomethacin in all patients undergoing ERCP reduces the risk of PEP. Pancreatic-duct stents reduce the risk of PEP in high-risk patients. There is emerging data that aggressive hydration with lactated Ringer’s and nitrates may further reduce PEP. Tacrolimus is a promising potential agent to prevent PEP but needs further clinical study.
ISSN:1522-8037
1534-312X
DOI:10.1007/s11894-020-00796-w