<trans-title xml:lang="en"/>_West China Medical Journal

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 ^1,2 , ² , ¹

1. ;
2. ;

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, Email: lujing69@foxmail.com

Keywords：

内镜下逆行胰胆管造影; 胰腺炎; 预防

DOI：

10.7507/1002-0179.201512056

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经内镜逆行胰胆管造影（endoscopic retrograde cholangilpancreatography，ERCP）应用于临床已有 40 余年，该微创内镜介入技术的优点是将诊断和治疗完美融于一体，随着 ERCP 技术及设备的不断发展，该技术已成为目前诊断和治疗胰胆管疾病的重要手段之一。与此同时，ERCP 术后并发症的发生以及如何有效防治也日益受到重视。其中 ERCP 术后胰腺炎（post-ERCP pancreatitis，PEP）是最常见的并发症，该文就 PEP 的预防进展进行了综述。

Citation： 卢静, 王春晖, 钟显飞. . West China Medical Journal, 2017, 32(2): 262-266. doi: 10.7507/1002-0179.201512056 Copy

1.	Cheng CL, Sherman S, Watkins JL, et al. Risk factors for post-ERCP pancreatitis: a prospective multicenter study. Am J Gastroenterol, 2006, 101(1): 139-147.
2.	Williams EJ, Taylor S, Fairclough P, et al. Risk factors for complication following ERCP; results of a large-scale, prospective multicenter study. Endoscopy, 2007, 39(9): 793-801.
3.	Freeman ML. Adverse outcomes of ERCP. Gastrointest Endosc, 2002, 56(6S): S273-S282.
4.	Maranki J, Yeaton P. Prevention of post-ERCP pancreatitis. Curr Gastroenterol Rep, 2013, 15(11): 352.
5.	Dumonceau JM, Andriulli A, Elmunzer BJ, et al. Prophylaxis of post-ERCP pancreatitis: European Society of Gastrointestinal Endoscopy (ESGE) Guideline- updated June 2014. Endoscopy, 2014, 46(9): 799-815.
6.	Donnellan F, Byrne MF. Prevention of post-ERCP pancreatitis. Gastroenterol Res Pract, 2012, 2012: 796751.
7.	Kubiliun M, Elmunzer J. Preventing pancreatitis after endoscopic retrograde cholangiopancreatography. Gastrointest Endosc Clin N Am, 2013, 23(4): 769-786.
8.	Sahakian AB, Buxbaum JL, Van Dam J. Prevention and management of post-ERCP pancreatitis. JOP, 2014, 15(6): 544-551.
9.	Freeman L. Complications of endoscopic biliary sphincterotomy: a review. Endoscopy, 1997, 29(4): 288-297.
10.	Hawes H. The evolution of endoscopic ultrasound: improved imaging, higher accuracy for fine needle aspiration and the reality of endoscopic ultrasound-guided interventions. Curr Opin Gastroenterol, 2010, 26(5): 436-444.
11.	Choudhary A, Bechtold ML, Arif MA, et al. Pancreatic stents for prophylaxis against post-ERCP pancreatitis: a meta-analysis and systematic review. Gastrointest Endosc, 2011, 73(2): 275-282.
12.	Mazaki T, Mado K, Masuda H, et al. Prophylactic pancreatic stent placement and post-ERCP pancreatitis: an updated meta-analysis. J Gastroenterol, 2014, 49(2): 343-355.
13.	Freeman L. Complications of endoscopic retrograde cholangiopancreatography: avoidance and management. Gastrointest Endosc Clin N Am, 2012, 22(3): 567-586.
14.	Cha W, Leung D, Lehman A, et al. Does leaving a main pancreatic duct stent in place reduce the incidence of precut biliary sphincterotomy-associated pancreatitis? A randomized, prospective study. Gastrointest Endosc, 2013, 77(2): 209-216.
15.	Zolotarevsky E, Fehmi M, Anderson A, et al. Prophylactic 5-Fr pancreatic duct stents are superior to 3-Fr stents: a randomized controlled trial. Endoscopy, 2011, 43(4): 325-330.
16.	Chahal P, Tarnasky R, Petersen T, et al. Short 5Fr vs long 3Fr pancreatic stents in patients at risk for post-endoscopic retrograde cholangiopancreatography pancreatitis. Clin Gastroenterol Hepatol, 2009, 7(8): 834-839.
17.	Tarnasky PR, Palesch YY, Cunningham JT, et al. Pancreatic stenting prevents pancreatitis after biliary sphincterotomy in patients with sphincter of oddi dysfunction. Gastroenterology, 1998, 115(6): 1518-1524.
18.	Lella F, Bagnolo F, Colombo E, et al. A simple way of avoiding post-ERCP pancreatitis. Gastrointest Endosc, 2004, 59(7): 830-834.
19.	Tse F, Yuan Y, Moayyedi P, et al. Guidewire-assisted cannulation of the common bile duct for the prevention of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis. Cochrane Database Syst Rev, 2012, 12: CD009662.
20.	Tse F, Yuan Y, Moayyedi P, et al. Guide wire-assisted cannulation for the prevention of post-ERCP pancreatitis: a systematic review and meta-analysis. Endoscopy, 2013, 45(8): 605-618.
21.	Baron TH, Irani S. Prevention of post-ERCP pancreatitis. Minerva Med, 2014, 105(2): 129-136.
22.	Bailey A, Bourke J, Kaffes J, et al. Needle-knife sphincterotomy: factors predicting its use and the relationship with post-ERCP pancreatitis (with video). Gastrointest Endosc, 2010, 71(2): 266-271.
23.	Ding X, Chen M, Huang S, et al. Nonsteroidal anti-inflammatory drugs for prevention of post-ERCP pancreatitis: a meta-analysis. Gastrointest Endosc, 2012, 76(6): 1152-1159.
24.	Otsuka T, Kawazoe S, Nakashita S, et al. Low-dose rectal diclofenac for prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis: a randomized controlled trial. J Gastroenterol, 2012, 47(8): 912-917.
25.	Balmadrid B, Kozarek R. Prevention and management of adverse events of endoscopic retrograde cholangiopancreatography. Gastrointest Endosc Clin N Am, 2013, 23(2): 385-403.
26.	Feurer ME, Adler DG. Post-ERCP pancreatitis: review of current preventive strategies. Curr Opin Gastroenterol, 2012, 28(3): 280-286.
27.	Elmunzer BJ, Scheiman JM, Lehman GA, et al. A randomized trial of rectal indomethacin to prevent post-ERCP pancreatitis. N Engl J Med, 2012, 366(15): 1414-1422.
28.	Yoo KS, Huh KR, Kim YJ, et al. Nafamostat mesilate for prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis: a prospective, randomized, double-blind, controlled trial. Pancreas, 2011, 40(2): 181-186.
29.	Park KT, Kang DH, Choi CW, et al. Is high-dose nafamostat mesilate effective for the prevention of post-ERCP pancreatitis, especially in high-risk patients?. Pancreas, 2011, 40(8): 1215-1219.
30.	Seta T, Noguchi Y. Protease inhibitors for preventing complications associated with ERCP: an updated meta-analysis. Gastrointest Endosc, 2011, 73(4): 700-706.
31.	Yoo JW, Ryu JK, Lee SH, et al. Preventive effects of ulinastatin on post-endoscopic retrograde cholangiopancreatography pancreatitis in high-risk patients: a prospective, randomized, placebo-controlled trial. Pancreas, 2008, 37(4): 366-370.
32.	Katsinelos P, Fasoulas K, Paroutoglou G, et al. Combination of diclofenac plus somatostatin in the prevention of post-ERCP pancreatitis: a randomized, double-blind, placebo-controlled trial. Endoscopy, 2012, 44(1): 53-59.
33.	Wang ZK, Yang YS, Cai FC, et al. Is prophylactic somatostatin effective to prevent post-endoscopic retrograde cholangiopancreatography pancreatitis or hyperamylasemia? A randomized, placebo-controlled pilot trial. Chin Med J (Engl), 2013, 126(13): 2403-2408.
34.	Omata F, Tokuda Y, Takahashi O, et al. Meta-analysis: somatostatin or its long-acting analogue, octreotide, for prophylaxis against post-ERCP pancreatitis. J Gastroenterol, 2010, 45(Issue 8): 885-895.
35.	Ding J, Jin X, Pan Y, et al. Glyceryl trinitrate for prevention of post-ERCP pancreatitis and improve the rate of cannulation: a meta-analysis of prospective, randomized, controlled trials. PLoS One, 2013, 8(10): e75645.
36.	Akshintala S, Hutfless M, Colantuoni E, et al. Systematic review with network meta-analysis: pharmacological prophylaxis against post-ERCP pancreatitis. Aliment Pharmacol Ther, 2013, 38(11/12): 1325-1337.
37.	Räty S, Sand J, Pulkkinen M, et al. Post-ERCP pancreatitis: reduction by routine antibiotics. J Gastrointest Surg, 2002, 5(4): 339-345.
38.	Buxbaum J, Yan A, Yeh K, et al. Aggressive hydration with lactated Ringer’s solution reduces pancreatitis after endoscopic retrograde cholangiopancreatography. Clin Gastroenterol Hepatol, 2014, 12(2): 303-307.
39.	Sagi V, Schmidt S, Fogel E, et al. Association of greater intravenous volume infusion with shorter hospitalization for patients with post-ERCP pancreatitis. J Gastroenterol Hepatol, 2014, 29(6): 1316-1320.
40.	Dimagno J, Wamsteker J, Maratt J, et al. Do larger periprocedural fluid volumes reduce the severity of post-endoscopic retrograde cholangiopancreatography pancreatitis?. Pancreas, 2014, 43(4): 642-647.
41.	Bai Y, Gao J, Shi X, et al. Prophylactic corticosteroids do not prevent post-ERCP pancreatitis:a meta-analysis of randomized controlled trials. Pancreatology, 2008, 8(4/5): 504-509.
42.	Zheng M, Chen Y, Bai J, et al. Meta-analysis of prophylactic allopurinol use in post-endoscopic retrograde cholangiopancreatography pancreatitis. Pancreas, 2008, 37(3): 247-253.

1. Cheng CL, Sherman S, Watkins JL, et al. Risk factors for post-ERCP pancreatitis: a prospective multicenter study. Am J Gastroenterol, 2006, 101(1): 139-147.
2. Williams EJ, Taylor S, Fairclough P, et al. Risk factors for complication following ERCP; results of a large-scale, prospective multicenter study. Endoscopy, 2007, 39(9): 793-801.
3. Freeman ML. Adverse outcomes of ERCP. Gastrointest Endosc, 2002, 56(6S): S273-S282.
4. Maranki J, Yeaton P. Prevention of post-ERCP pancreatitis. Curr Gastroenterol Rep, 2013, 15(11): 352.
5. Dumonceau JM, Andriulli A, Elmunzer BJ, et al. Prophylaxis of post-ERCP pancreatitis: European Society of Gastrointestinal Endoscopy (ESGE) Guideline- updated June 2014. Endoscopy, 2014, 46(9): 799-815.
6. Donnellan F, Byrne MF. Prevention of post-ERCP pancreatitis. Gastroenterol Res Pract, 2012, 2012: 796751.
7. Kubiliun M, Elmunzer J. Preventing pancreatitis after endoscopic retrograde cholangiopancreatography. Gastrointest Endosc Clin N Am, 2013, 23(4): 769-786.
8. Sahakian AB, Buxbaum JL, Van Dam J. Prevention and management of post-ERCP pancreatitis. JOP, 2014, 15(6): 544-551.
9. Freeman L. Complications of endoscopic biliary sphincterotomy: a review. Endoscopy, 1997, 29(4): 288-297.
10. Hawes H. The evolution of endoscopic ultrasound: improved imaging, higher accuracy for fine needle aspiration and the reality of endoscopic ultrasound-guided interventions. Curr Opin Gastroenterol, 2010, 26(5): 436-444.
11. Choudhary A, Bechtold ML, Arif MA, et al. Pancreatic stents for prophylaxis against post-ERCP pancreatitis: a meta-analysis and systematic review. Gastrointest Endosc, 2011, 73(2): 275-282.
12. Mazaki T, Mado K, Masuda H, et al. Prophylactic pancreatic stent placement and post-ERCP pancreatitis: an updated meta-analysis. J Gastroenterol, 2014, 49(2): 343-355.
13. Freeman L. Complications of endoscopic retrograde cholangiopancreatography: avoidance and management. Gastrointest Endosc Clin N Am, 2012, 22(3): 567-586.
14. Cha W, Leung D, Lehman A, et al. Does leaving a main pancreatic duct stent in place reduce the incidence of precut biliary sphincterotomy-associated pancreatitis? A randomized, prospective study. Gastrointest Endosc, 2013, 77(2): 209-216.
15. Zolotarevsky E, Fehmi M, Anderson A, et al. Prophylactic 5-Fr pancreatic duct stents are superior to 3-Fr stents: a randomized controlled trial. Endoscopy, 2011, 43(4): 325-330.
16. Chahal P, Tarnasky R, Petersen T, et al. Short 5Fr vs long 3Fr pancreatic stents in patients at risk for post-endoscopic retrograde cholangiopancreatography pancreatitis. Clin Gastroenterol Hepatol, 2009, 7(8): 834-839.
17. Tarnasky PR, Palesch YY, Cunningham JT, et al. Pancreatic stenting prevents pancreatitis after biliary sphincterotomy in patients with sphincter of oddi dysfunction. Gastroenterology, 1998, 115(6): 1518-1524.
18. Lella F, Bagnolo F, Colombo E, et al. A simple way of avoiding post-ERCP pancreatitis. Gastrointest Endosc, 2004, 59(7): 830-834.
19. Tse F, Yuan Y, Moayyedi P, et al. Guidewire-assisted cannulation of the common bile duct for the prevention of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis. Cochrane Database Syst Rev, 2012, 12: CD009662.
20. Tse F, Yuan Y, Moayyedi P, et al. Guide wire-assisted cannulation for the prevention of post-ERCP pancreatitis: a systematic review and meta-analysis. Endoscopy, 2013, 45(8): 605-618.
21. Baron TH, Irani S. Prevention of post-ERCP pancreatitis. Minerva Med, 2014, 105(2): 129-136.
22. Bailey A, Bourke J, Kaffes J, et al. Needle-knife sphincterotomy: factors predicting its use and the relationship with post-ERCP pancreatitis (with video). Gastrointest Endosc, 2010, 71(2): 266-271.
23. Ding X, Chen M, Huang S, et al. Nonsteroidal anti-inflammatory drugs for prevention of post-ERCP pancreatitis: a meta-analysis. Gastrointest Endosc, 2012, 76(6): 1152-1159.
24. Otsuka T, Kawazoe S, Nakashita S, et al. Low-dose rectal diclofenac for prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis: a randomized controlled trial. J Gastroenterol, 2012, 47(8): 912-917.
25. Balmadrid B, Kozarek R. Prevention and management of adverse events of endoscopic retrograde cholangiopancreatography. Gastrointest Endosc Clin N Am, 2013, 23(2): 385-403.
26. Feurer ME, Adler DG. Post-ERCP pancreatitis: review of current preventive strategies. Curr Opin Gastroenterol, 2012, 28(3): 280-286.
27. Elmunzer BJ, Scheiman JM, Lehman GA, et al. A randomized trial of rectal indomethacin to prevent post-ERCP pancreatitis. N Engl J Med, 2012, 366(15): 1414-1422.
28. Yoo KS, Huh KR, Kim YJ, et al. Nafamostat mesilate for prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis: a prospective, randomized, double-blind, controlled trial. Pancreas, 2011, 40(2): 181-186.
29. Park KT, Kang DH, Choi CW, et al. Is high-dose nafamostat mesilate effective for the prevention of post-ERCP pancreatitis, especially in high-risk patients?. Pancreas, 2011, 40(8): 1215-1219.
30. Seta T, Noguchi Y. Protease inhibitors for preventing complications associated with ERCP: an updated meta-analysis. Gastrointest Endosc, 2011, 73(4): 700-706.
31. Yoo JW, Ryu JK, Lee SH, et al. Preventive effects of ulinastatin on post-endoscopic retrograde cholangiopancreatography pancreatitis in high-risk patients: a prospective, randomized, placebo-controlled trial. Pancreas, 2008, 37(4): 366-370.
32. Katsinelos P, Fasoulas K, Paroutoglou G, et al. Combination of diclofenac plus somatostatin in the prevention of post-ERCP pancreatitis: a randomized, double-blind, placebo-controlled trial. Endoscopy, 2012, 44(1): 53-59.
33. Wang ZK, Yang YS, Cai FC, et al. Is prophylactic somatostatin effective to prevent post-endoscopic retrograde cholangiopancreatography pancreatitis or hyperamylasemia? A randomized, placebo-controlled pilot trial. Chin Med J (Engl), 2013, 126(13): 2403-2408.
34. Omata F, Tokuda Y, Takahashi O, et al. Meta-analysis: somatostatin or its long-acting analogue, octreotide, for prophylaxis against post-ERCP pancreatitis. J Gastroenterol, 2010, 45(Issue 8): 885-895.
35. Ding J, Jin X, Pan Y, et al. Glyceryl trinitrate for prevention of post-ERCP pancreatitis and improve the rate of cannulation: a meta-analysis of prospective, randomized, controlled trials. PLoS One, 2013, 8(10): e75645.
36. Akshintala S, Hutfless M, Colantuoni E, et al. Systematic review with network meta-analysis: pharmacological prophylaxis against post-ERCP pancreatitis. Aliment Pharmacol Ther, 2013, 38(11/12): 1325-1337.
37. Räty S, Sand J, Pulkkinen M, et al. Post-ERCP pancreatitis: reduction by routine antibiotics. J Gastrointest Surg, 2002, 5(4): 339-345.
38. Buxbaum J, Yan A, Yeh K, et al. Aggressive hydration with lactated Ringer’s solution reduces pancreatitis after endoscopic retrograde cholangiopancreatography. Clin Gastroenterol Hepatol, 2014, 12(2): 303-307.
39. Sagi V, Schmidt S, Fogel E, et al. Association of greater intravenous volume infusion with shorter hospitalization for patients with post-ERCP pancreatitis. J Gastroenterol Hepatol, 2014, 29(6): 1316-1320.
40. Dimagno J, Wamsteker J, Maratt J, et al. Do larger periprocedural fluid volumes reduce the severity of post-endoscopic retrograde cholangiopancreatography pancreatitis?. Pancreas, 2014, 43(4): 642-647.
41. Bai Y, Gao J, Shi X, et al. Prophylactic corticosteroids do not prevent post-ERCP pancreatitis:a meta-analysis of randomized controlled trials. Pancreatology, 2008, 8(4/5): 504-509.
42. Zheng M, Chen Y, Bai J, et al. Meta-analysis of prophylactic allopurinol use in post-endoscopic retrograde cholangiopancreatography pancreatitis. Pancreas, 2008, 37(3): 247-253.

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