Pre- and post-procedure risk prediction models for post-endoscopic retrograde cholangiopancreatography pancreatitis

Park, Chan Hyuk; Park, Se Woo; Yang, Min Jae; Moon, Sung Hoon; Park, Da Hae

doi:10.1007/s00464-021-08491-1

Cited by 25 publications

(15 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The scoring system included younger age (⩽65 years), female sex, previous acute pancreatitis, and malignant biliary obstruction as independent risk factors for the development of PEP. 63 Although the incidence of PEP in the validation cohort was greater in the high-risk group (6.9%) when compared to the low- (2.2%) and the moderate-risk groups (3.8%), the difference was not statistically significant ( p > 0.05). 63 …”

Section: Patient Selection and Risk Stratification In The Prevention ...mentioning

confidence: 73%

See 1 more Smart Citation

Prevention of post-ERCP pancreatitis: current strategies and novel perspectives

Andreis

Mascagni

Schepis

et al. 2023

Therap Adv Gastroenterol

View full text Add to dashboard Cite

Endoscopic retrograde cholangiopancreatography (ERCP) is an advanced endoscopic procedure that might lead to severe adverse events. Post-ERCP pancreatitis (PEP) is the most common post-procedural complication, which is related to significant mortality and increasing healthcare costs. Up to now, the prevalent approach to prevent PEP consisted of employing pharmacological and technical expedients that have been shown to improve post-ERCP outcomes, such as the administration of rectal nonsteroidal anti-inflammatory drugs, aggressive intravenous hydration, and the placement of a pancreatic stent. However, it has been reported that PEP originates from a more complex interaction of procedural and patient-related factors. Appropriate ERCP training has a pivotal role in PEP prevention strategy, and it is not a chance that a low PEP rate is universally considered one of the most relevant indicators of proficiency in ERCP. Scant data on the acquisition of skills during the ERCP training are currently available, although some efforts have been recently done to shorten the learning curve by way of simulation-based training and demonstrate competency by meeting technical requirements as well as adopting skill evaluation scales. Besides, the identification of adequate indications for ERCP and accurate pre-procedural risk stratification of patients might help to reduce PEP occurrence regardless of the endoscopist’s technical abilities, and generally preserve safety in ERCP. This review aims at delineating current preventive strategies and highlighting novel perspectives for a safer ERCP focusing on the prevention of PEP.

show abstract

Section: Patient Selection and Risk Stratification In The Prevention ...mentioning

confidence: 73%

“… 63 Although the incidence of PEP in the validation cohort was greater in the high-risk group (6.9%) when compared to the low- (2.2%) and the moderate-risk groups (3.8%), the difference was not statistically significant ( p > 0.05). 63 …”

Section: Patient Selection and Risk Stratification In The Prevention ...mentioning

confidence: 73%

Prevention of post-ERCP pancreatitis: current strategies and novel perspectives

Andreis

Mascagni

Schepis

et al. 2023

Therap Adv Gastroenterol

View full text Add to dashboard Cite

show abstract

“…[83,84] Certain models have been proposed to predict the risk of PEP; however, none have been adopted for widespread use. [46,85] In conclusion, the mainstays of management for PEP prevention are multifactorial: patient selection, accurate assessment of risk, pharmacologic, use of pancreatic stents, adequate IV hydration, and appropriate technique selection (Fig. 2).…”

Section: Discussionmentioning

confidence: 99%

“…[83,84] Certain models have been proposed to predict the risk of PEP; however, none have been adopted for widespread use. [46,85]…”

Section: Discussionmentioning

confidence: 99%

“…Considering the weight of certain risk factors for an individual has led to the development of various prognostic models for predicting risk. [45][46][47] None have been widely adopted due to a variety of reasons including the use of retrospective data for the development of these models or inability to adequately assess interactions between risk factors. Machine-learning-based tools have more recently been proposed to assess PEP risk and guide prophylactic strategy selection.…”

Section: Risk Stratificationmentioning

confidence: 99%

See 1 more Smart Citation

Post-endoscopic retrograde cholangiopancreatography pancreatitis: a review

Patel,

Akshintala

2023

Journal of Pancreatology

View full text Add to dashboard Cite

Endoscopic retrograde cholangiopancreatography (ERCP) has continued to develop over recent decades with regards to both indications for its use and improvements in technique. The most common complication is post- endoscopic retrograde cholangiopancreatography pancreatitis (PEP) with incidence rates being reported at ~10%. The exact mechanism of PEP is unknown but is likely multi-factorial with papillary edema contributing to the activation of the inflammatory cascade playing an important role. Selected risk factors include patient-related factors (female, sex, younger age, sphincter of Oddi dysfunction, and history of PEP) and procedure-related factors (difficult cannulation, multiple pancreatic duct guidewire passes, pancreatic acinarization, multiple pancreatic duct contrast injections and precut sphincterotomy). Several preventative prophylactic strategies have been posited; however, current guidelines recommend the use of rectal NSAIDs, aggressive IV fluid hydration and pancreatic duct stents. Appropriate patient selection and the use of non-invasive imaging modalities for diagnosis of pancreaticobiliary abnormalities is a key aspect in prevention. Future studies continue to explore various pharmacologic, procedure-related and combination strategies for prevention and will be important as the use of ERCP continues to grow.

show abstract

Post-ERCP Pancreatitis and Prevention

Akshintala,

Singh

2024

Acute Pancreatitis

View full text Add to dashboard Cite

Pre- and post-procedure risk prediction models for post-endoscopic retrograde cholangiopancreatography pancreatitis

Cited by 25 publications

References 20 publications

Prevention of post-ERCP pancreatitis: current strategies and novel perspectives

Prevention of post-ERCP pancreatitis: current strategies and novel perspectives

Post-endoscopic retrograde cholangiopancreatography pancreatitis: a review

Post-ERCP Pancreatitis and Prevention

Contact Info

Product

Resources

About