NSAIDs for prevention of pancreatitis after endoscopic retrograde cholangiopancreatography: ready for prime time?
Acute pancreatitis is the most common and the most fearful complication of endoscopic retrograde cholangiopancreatography (ERCP). Prevention of post-ERCP pancreatitis has therefore been of great interest to endoscopists performing ERCP procedures. So far, only pancreatic duct stenting during ERCP and rectal administration of a non-steroidal anti-inflammatory drug (NSAID) prior to or immediately after ERCP have been consistently shown to be effective for prevention of post-ERCP pancreatitis. This commentary focuses on a short discussion about the rates, mechanisms, and risk factors for post-ERCP pancreatitis, and effective means for its prevention with emphasis on the use of NSAIDs including a recent clinical trial published in The New England Journal of Medicine by Elmunzer et al([11]).
Section for Therapeutic and Pancreatobiliary Endoscopy, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH 44195, United States. parsim@ccf.org
Mansour A
MA
Parsi
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects*; D006801:Humans; D010195:Pancreatitis / Q000209:etiology / Q000517:prevention & control*; D012307:Risk Factors
D000894:Anti-Inflammatory Agents, Non-Steroidal