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Related Concept Videos

Endoscopic Procedures V: ERCP01:26

Endoscopic Procedures V: ERCP

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Endoscopic Retrograde Cholangiopancreatography (ERCP) is a diagnostic procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions related to the bile ducts, pancreatic ducts, and gallbladder. This procedure is beneficial for identifying and addressing blockages, gallstones, strictures, and tumors within the biliary or pancreatic systems. ERCP is both diagnostic and therapeutic, offering the ability to visualize and treat identified problems in one session.
Patient...
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Chronic Pancreatitis II: Collaborative Care01:29

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The management of chronic pancreatitis is multifaceted, involving a comprehensive approach that includes thorough assessment, diagnostic testing, and a variety of management strategies.
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Acute Pancreatitis II: Clinical Manifestations and Management01:30

Acute Pancreatitis II: Clinical Manifestations and Management

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Acute pancreatitis presents a complex medical emergency characterized by rapid onset inflammation of the pancreas, demanding timely diagnosis and management to prevent complications. The condition primarily manifests through severe upper abdominal pain that often radiates to the back. This pain intensifies following the consumption of fatty foods. Accompanying symptoms such as nausea, vomiting, abdominal distention, fever, dyspnea, cyanosis, and jaundice can vary in intensity but significantly...
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Chronic Pancreatitis I: Introduction01:24

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The pancreas, an elongated and flat gland situated behind the stomach, serves a vital function in digesting food and managing blood sugar levels.
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Acute Pancreatitis I: Introduction01:27

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Pancreatitis is inflammation of the pancreas, an organ located behind the stomach. It can be either acute or chronic.
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When developing expected outcomes for a patient care plan, the nurse should adhere to the following recommendations:
Patient outcomes reflect the patient's response to the goal rather than what the nurse aims to achieve. Terminology should be observable and measurable to avoid the reader's interpretation. The desired outcome should be realistic and achievable in the designated care timeframe. Expected outcomes should align with adjunctive therapies. The outcome should enhance care...
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Clinical Practice Guidelines for post-ERCP pancreatitis 2023.

Shuntaro Mukai1, Yoshifumi Takeyama2, Takao Itoi1

  • 1Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.

Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society
|March 25, 2025
PubMed
Summary
This summary is machine-generated.

Updated clinical practice guidelines offer evidence-based strategies for preventing, diagnosing, and managing post-ERCP pancreatitis (PEP). Key recommendations include pancreatic duct stents and NSAIDs to reduce PEP incidence in patients undergoing ERCP.

Keywords:
clinical practice guidelineendoscopic retrograde cholangiopancreatographynonsteroidal anti‐inflammatory drugspost‐ERCP pancreatitistemporary pancreatic duct stent

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Area of Science:

  • Gastroenterology
  • Clinical Practice Guidelines
  • Pancreatology

Background:

  • Post-ERCP pancreatitis (PEP) is the most frequent complication of endoscopic retrograde cholangiopancreatography (ERCP).
  • Advances in ERCP techniques and new research necessitate guideline updates since 2015.
  • The guidelines focus on adult patients undergoing ERCP.

Purpose of the Study:

  • Provide updated, evidence-based recommendations for PEP prevention, diagnosis, and management.
  • Establish a comprehensive framework for clinicians to minimize PEP risk.
  • Incorporate the GRADE methodology for guideline development.

Main Methods:

  • Utilized the GRADE methodology for evidence assessment and guideline formulation.
  • Reviewed procedural and patient-related risk factors for PEP.
  • Synthesized current research on diagnostic criteria and treatment protocols for PEP.

Main Results:

  • Recommends endoscopic ultrasound for high-risk patients to avoid unnecessary ERCP procedures.
  • Highlights that operator experience is less critical than skilled supervision in affecting PEP rates.
  • Suggests monitoring serum pancreatic enzyme levels and early CT scans for diagnosis.
  • Recommends standard acute pancreatitis treatment protocols.
  • Strongly supports temporary pancreatic duct stents and rectal NSAIDs for PEP prevention.

Conclusions:

  • The 2023 guidelines offer a robust framework for reducing PEP incidence and improving patient outcomes.
  • Evidence-based preventive measures like pancreatic stents and NSAIDs are crucial.
  • Adherence to updated diagnostic and management strategies is essential for clinical practice.