摘要
Endoscopic retrograde cholangiopancreatography is a diagnostic and therapeutic procedure for various gastrointestinal prob-lems.Pancreatitis is a severe complication of the procedure.The main objective of this study was to address if post-endoscop-ic retrograde cholangiopancreatography(ERCP)pancreatitis can be prevented and what are the various pharmacological and non-pharmacological options along with their efficacy.Keywords“post-ERCP”and“pancreatitis”were used to search articles in Pubmed.Randomized controlled trials on patients undergoing ERCP due to any disease using pharmacological or non-pharma-cological intervention published in the last 7 years were included.Observational studies,descriptive studies,reviews,and studies with no full access were excluded.The primary outcome in the trials was a frequency of post-ERCP pancreatitis.Non-steroidal anti-inflammatory drugs(NSAIDs)were the most effective drugs in reducing the incidence of pancreatitis.The preferred route was rectal.After NSAIDs,intravenous hydration and sublingual nitrate showed promising outcomes,especially when combined with rectal NSAIDs.Other drugs like magnesium sulfate and nafamostat mesilate did reduce the incidence,but the results were not statistically significant.Epinephrine spray on duodenal papilla showed no benefits and instead had a risk of increasing the incidence.Stent placement also reduced the incidence of pancreatitis.In conclusion,rectal NSAIDs alone or combined with IV hydration and sublingual nitrate significantly reduced the incidence of pancreatitis,and stent placement was comparable to pharmacological interventions.Thus,regular use of pharmacological interventions before the procedure can help to reduce the incidence of this grave complication.
