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Current Gastroenterology Reports

Erschienen in:

01.12.2020 | Endoscopy and Surgery (S Komanduri, Section Editor)

Emerging Therapies to Prevent Post-ERCP Pancreatitis

verfasst von: Nikhil R. Thiruvengadam, Michael L. Kochman

Erschienen in: Current Gastroenterology Reports | Ausgabe 12/2020

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Abstract

Purpose of Review

The aim of this review is to evaluate emerging, novel therapies for the prevention of post-ERCP pancreatitis.

Recent Findings

Rectal indomethacin reduces the risk of pancreatitis in low- and average-risk patients, who comprise the majority of patients undergoing ERCP. An 8-h protocol of aggressive lactated Ringer’s reduces the risk of pancreatitis in average-risk patients. Sublingual nitrate may provide additional benefit to rectal NSAIDs in preventing PEP. A tacrolimus trough > 2.5 ng/mL was recently shown to be associated with a lower risk of PEP in liver transplant patients undergoing ERCP.

Summary

Routine usage of rectal indomethacin in all patients undergoing ERCP reduces the risk of PEP. Pancreatic-duct stents reduce the risk of PEP in high-risk patients. There is emerging data that aggressive hydration with lactated Ringer’s and nitrates may further reduce PEP. Tacrolimus is a promising potential agent to prevent PEP but needs further clinical study.

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Titel: Emerging Therapies to Prevent Post-ERCP Pancreatitis
verfasst von: Nikhil R. Thiruvengadam
Michael L. Kochman
Publikationsdatum: 01.12.2020
Verlag: Springer US
Erschienen in: Current Gastroenterology Reports / Ausgabe 12/2020
Print ISSN: 1522-8037
Elektronische ISSN: 1534-312X
DOI: https://doi.org/10.1007/s11894-020-00796-w

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