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World J Gastroenterol. Feb 7, 2013; 19(5): 631-637
Published online Feb 7, 2013. doi: 10.3748/wjg.v19.i5.631
Prophecy about post-endoscopic retrograde cholangiopancreatography pancreatitis: From divination to science
Sung-Hoon Moon, Myung-Hwan Kim
Sung-Hoon Moon, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 431-070, South Korea
Myung-Hwan Kim, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul 138-736, South Korea
Author contributions: Moon SH and Kim MH wrote the paper; Moon SH and Kim MH advised and informed about the knowledge.
Correspondence to: Myung-Hwan Kim, MD, PhD, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Asanbyeongwon-Gil 86, Songpa-Gu, Seoul 138-736, South Korea. mhkim@amc.seoul.kr
Telephone: +82-2-30103183 Fax: +82-41-5563256
Received: October 15, 2012
Revised: December 28, 2012
Accepted: January 11, 2013
Published online: February 7, 2013
Processing time: 113 Days and 16.2 Hours
Abstract

One unresolved issue of endoscopic retrograde cholangiopancreatography (ERCP) is post-ERCP pancreatitis (PEP), which occurs in up to 40% of patients. Identification of risk factors for PEP is especially important in the field of ERCP practice because it may assist physicians in taking protective measures in situations with high risk. A decade ago, Freeman et al meticulously evaluated a large number of potentially relevant risk factors for PEP, which can be divided into patient-related and procedure-related issues. In this commentary, we summarize this classic article and reevaluate the risk factors for PEP from the current point of view. This is followed by assessment of strategies for prevention of PEP that can be divided into mechanical and pharmacologic methods.

Keywords: Endoscopic retrograde cholangiopancreatography; Post-endoscopic retrograde cholangiopancreatography pancreatitis; Risk factor; Prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis; Pancreatic stents; Nonsteroidal antiinflammatory drugs