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World J Gastroenterol. Nov 28, 2014; 20(44): 16582-16595
Published online Nov 28, 2014. doi: 10.3748/wjg.v20.i44.16582
Endoscopic prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis
Tae Hoon Lee, Do Hyun Park
Tae Hoon Lee, Division of Gastroenterology, Department of Internal Medicine, Soonchunhyang University School of Medicine, Cheonan Hospital, Seoul 330-721, South Korea
Do Hyun Park, Division of Gastroenterology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul 330-721, South Korea
Author contributions: Lee TH wrote the manuscript; Park DH developed the concept and revised the manuscript.
Correspondence to: Do Hyun Park, MD, PhD, Division of Gastroenterology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, 388-1 Pungnap-2dong, Songpagu, Seoul 330-721, South Korea. dhpark@amc.seoul.kr
Telephone: +82-2-30103180 Fax: +82-2-4855782
Received: January 24, 2014
Revised: March 11, 2014
Accepted: April 28, 2014
Published online: November 28, 2014
Processing time: 311 Days and 14.4 Hours
Core Tip

Core tip: Endoscopic prevention and/or reduction in the severity of pancreatitis (PEP) are considered to be an essential component of appropriate therapy for Post-endoscopic retrograde cholangiopancreatography patients, especially those at high risk. Numerous techniques and drugs have been developed. However, their proven benefits in terms of reducing the severity of pancreatitis are limited. Currently, one popular endoscopic method is prophylactic placement of a pancreatic stent. In this review, we focus primarily on the ideal type of stent, the timing of stent insertion, and the duration of stent placement adequate to prevent PEP. Also, we describe initial cannulation methods including wire-guided cannulation and precut fistulotomy (infundibulotomy), and the alternative techniques of percutaneous biliary drainage and recently emerging endoscopic ultrasonography-guided methodology.