Clinical Practice Guidelines for post-ERCP pancreatitis 2023

Shuntaro Mukai, Yoshifumi Takeyama, Takao Itoi*, Tsukasa Ikeura, Atsushi Irisawa, Eisuke Iwasaki, Akio Katanuma, Katsuya Kitamura, Mamoru Takenaka, Morihisa Hirota, Toshihiko Mayumi, Toshio Morizane, Ichiro Yasuda, Shomei Ryozawa, Atsushi Masamune

*この論文の責任著者

研究成果: ジャーナルへの寄稿学術論文査読

抄録

The Clinical Practice Guidelines for post-ERCP pancreatitis (PEP) 2023 provide updated recommendations for the prevention, diagnosis, and management of PEP. Endoscopic retrograde cholangiopancreatography (ERCP), a valuable procedure for diagnosing and treating pancreatobiliary diseases, can result in PEP as the most common adverse event. Since the first guidelines were published in 2015, advances in techniques and new research findings have necessitated this revision. The guidelines developed using the GRADE methodology target adult patients undergoing ERCP. They offer a comprehensive framework for clinicians to minimize the risk of PEP. For high-risk patients, endoscopic ultrasound before ERCP is recommended to avoid unnecessary procedures. The guidelines also discuss procedural and patient-related risk factors for PEP, highlighting that operator experience does not significantly affect PEP rates if performed under the supervision of skilled endoscopists. The diagnostic criteria include monitoring serum pancreatic enzyme levels postprocedure, and early computed tomography is advised in suspected cases. For treatment, the guidelines recommend following acute pancreatitis protocols. Key preventive measures include the use of temporary pancreatic duct stents and rectal nonsteroidal anti-inflammatory drugs, both of which are supported by strong evidence for reducing the incidence of PEP. Overall, these guidelines aim to enhance clinical outcomes by reducing PEP incidence and improving its management through evidence-based practices.

本文言語英語
ジャーナルDigestive Endoscopy
DOI
出版ステータス受理済み/印刷中 - 2025

ASJC Scopus 主題領域

  • 放射線学、核医学およびイメージング
  • 消化器病学

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