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Clinical practice guideline for post-ERCP pancreatitis
Tetsuya Mine1, Toshio Morizane2, Yoshiaki Kawaguchi3
1Tokai University, School of Medicine, Isehara, Japan. tetsu-m@is.icc.u-tokai.ac.jp.
Insights
This clinical practice guideline addresses post-ERCP pancreatitis (PEP), a complication of endoscopic retrograde cholangiopancreatography (ERCP). It provides recommendations for managing PEP, aiding gastroenterologists in patient care.
Area of Science:
- Gastroenterology
- Medical Guidelines
Background:
- Endoscopic retrograde cholangiopancreatography (ERCP) is a procedure for diagnosing and treating pancreatic and biliary diseases.
- Post-ERCP pancreatitis (PEP) is a known complication requiring specialized care and clinical guidelines.
Purpose of the Study:
- To develop a clinical practice guideline for the diagnosis and management of Post-ERCP pancreatitis (PEP).
- To address key clinical questions regarding PEP, including risk factors, diagnosis, treatment, and prevention.
Main Methods:
- Formulated clinical questions based on key issues in PEP diagnosis and treatment.
- Conducted literature searches in PubMed (MEDLINE) and Ichushi-web.
- Assessed diagnostic test accuracy using QUADAS-2-like criteria and graded recommendations.
Main Results:
- Developed ten clinical questions with recommendations and explanations for PEP.
- Covered risk factors, diagnosis, prognostic factors, treatments, and preventive interventions for PEP.
Conclusions:
- This report presents the core elements of the clinical practice guideline for PEP.
- The guideline is intended for gastroenterologists to inform clinical practice regarding PEP management.
Background:
Endoscopic retrograde cholangiopancreatography (ERPC) is used for the diagnosis and treatment of pancreatic and biliary diseases. Post-ERCP pancreatitis (PEP) is a complication which needs special care and clinical practice guideline for this morbidity is also needed.
Methods:
The key clinical issues of diagnosis and treatment of PEP were listed and checked, and then the clinical questions were formulated. PubMed (MEDLINE) and Ichushi-web (Japanese medical literature) were used as databases. For the study of diagnostic test accuracy, items similar to QUADAS-2, i.e., random selection from a population to which the diagnostic test is applied, blinding of index tests and reference tests, completeness of reference standard, completeness of test implementations, the same timing of tests, and missing data were assessed as well as the indirectness of the study subjects, index tests, reference standard, and outcomes. Grading of recommendations was determined as strong or weak. In clinical practice, the judgment of attending doctors should be more important than recommendations described in clinical practice guidelines. Gastroenterologists are the target users of this clinical practice guideline. General practitioners or general citizens are not supposed to use this guideline. The guideline committee has decided to include wide clinical issues such as etiological information, techniques of ERCP, the diagnosis, treatments, and monitoring of PEP in this guideline.
Results:
In this concise report, we described ten clinical questions, recommendations, and explanations pertaining to risk factors, diagnosis, prognostic factors, treatments, and preventive interventions in the medical practice for PEP.
Conclusions:
We reported here the essence of the clinical practice guideline for PEP.
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