POST-ERCP-PANCREATITIS, THE PRESENT CONDITION AND MANAGEMENT, UP-TO-DATE

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  • ＥＲＣＰ後膵炎の現状と対策

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Various risk factors are evaluated on development of post-ERCP-pancreatitis. For the prevention of post-ERCP-pancreatitis, first, to identify of high risk factor of the post-ERCPpancreatitis is essential, and second to practice of possible clinical measures for avoiding it must be performed. Since the vicious circle between activation of trypsin and increase of the internal pressure of pancreatic duct is related greatly for the aggravation of post-ERCPpancreatitis, the administration of the protease inhibitor of enough quantities required for trypsin inhibition in pharmacology in early stage and decrease of the pancreatic duct internal pressure, such as pancreatic duct stenting, are expected for the prevention of aggravation of post-ERCP-pancreatitis. Although a prognosis improvement is expectable by the administration of protease in hibitor of enough quantities, for example continuous regional arterial infusion of protease inhibitor from early stage of pancreatitis, to post-ERCP-pancreatitis patients predicting aggravation of prognosis, there is a problem of the adaptation criteria which must be solved in early enforcement. In the future, the adaptation criteria of the early continuous regional arterial infusion of protease inhibitor enforcement to post-ERCP pancreatitis patient may be solved by introduction of Perfusion CT.

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