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World J Gastroenterol. Aug 14, 2012; 18(30): 3936-3937
Published online Aug 14, 2012. doi: 10.3748/wjg.v18.i30.3936
NSAIDs for prevention of pancreatitis after endoscopic retrograde cholangiopancreatography: Ready for prime time?
Mansour A Parsi
Mansour A Parsi, Section for Therapeutic and Pancreatobiliary Endoscopy, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH 44195, United States
Author contributions: Parsi MA contributed entirely to this manuscript.
Correspondence to: Mansour A Parsi, MD, MPH, Head, Section for Therapeutic and Pancreatobiliary Endoscopy, Digestive Disease Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, United States. parsim@ccf.org
Telephone: +1-216-4454880 Fax: +1-216-4446284
Received: May 31, 2012
Revised: June 15, 2012
Accepted: June 28, 2012
Published online: August 14, 2012
Abstract

Acute pancreatitis is the most common and the most fearful complication of endoscopic retrograde cholangiopancreatography (ERCP). Prevention of post-ERCP pancreatitis has therefore been of great interest to endoscopists performing ERCP procedures. So far, only pancreatic duct stenting during ERCP and rectal administration of a non-steroidal anti-inflammatory drug (NSAID) prior to or immediately after ERCP have been consistently shown to be effective for prevention of post-ERCP pancreatitis. This commentary focuses on a short discussion about the rates, mechanisms, and risk factors for post-ERCP pancreatitis, and effective means for its prevention with emphasis on the use of NSAIDs including a recent clinical trial published in The New England Journal of Medicine by Elmunzer et al[11].

Keywords: Endoscopic retrograde cholangiopancreatography; Pancreatitis; Post-endoscopic retrograde cholangiopancreatography pancreatitis; Pancreatic stents; Non-steroidal anti-inflammatory drugs