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ERCP- and endoscopic sphincterotomy-induced pancreatitis
1Division of Gastroenterology/Hepatology, Indiana University Medical Center, Indianapolis.
Pancreas
|May 1, 1991
Summary
Endoscopic retrograde cholangiopancreatography (ERCP) and sphincterotomy can cause pancreatitis due to various injuries. Careful patient selection and procedural attention can reduce the incidence of this complication.
Area of Science:
- Gastroenterology
- Endoscopic Procedures
- Pancreatic Diseases
Background:
- Endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic sphincterotomy are common procedures.
- These procedures can lead to a complication known as postprocedure pancreatitis.
- The pancreas is vulnerable to multiple injury types during these interventions.
Purpose of the Study:
- To detail the etiologic factors contributing to post-ERCP and post-endoscopic sphincterotomy pancreatitis.
- To review the management of this complication.
- To describe patient factors and preventive techniques for pancreatitis.
Main Methods:
- Review of potential injury mechanisms during ERCP and sphincterotomy (mechanical, chemical, hydrostatic, enzymatic, microbiological, allergic, thermal).
- Analysis of the role of each factor in inducing pancreatitis.
- Examination of management strategies, risk factors, and preventive measures.
Main Results:
- Multiple factors, acting alone or together, can cause pancreatitis post-procedure.
- Agents effective in animal models have largely failed in human trials.
- No single factor is solely responsible; a combination of injuries is implicated.
Conclusions:
- Postprocedure pancreatitis is an inherent risk of ERCP and endoscopic sphincterotomy.
- While complete elimination is unlikely, careful patient selection and meticulous technique are crucial for minimizing incidence.
- Further research into effective human preventative strategies is warranted.