預防內視鏡逆行性膽胰管造影術引發的胰臟炎之臨床指引

Clinical Guidelines for Prevention of Post-Endoscopic Retrograde Cholangiopancreatography (ERCP) Pancreatitis

內視鏡逆行性膽胰管造影術（endoscopic retrograde cholangiopancreatography, ERCP）廣泛用於診斷和治療胰臟和膽道系統疾病，術後最常見的併發症是胰臟炎（post-ERCP pancreatitis, PEP），可能延長病人住院時間並增加醫療支出，因此進行適當的預防便成了一項重要課題。PEP的預防可以從三大面向著手，分別為：病人風險的評估、預防藥物的使用、醫療技術相關措施的選用。本篇文章整理出目前美國、歐洲、日本、台灣相關的臨床指引中有提到的預防策略，進一步引用最新的研究文獻以供臨床人員參考，期望降低PEP的發生率，讓病人有更安全的醫療環境。

Endoscopic retrograde cholangiopancreatography(ERCP)is widely used to diagnose and manage pancreaticobiliary disorders in clinical practice. However, post-ERCP pancreatitis(PEP)is the most common adverse event attributing to the procedure that prolongs hospital stay and increases medical expenses. Thus, proper preventive strategies become an important issue. Prevention for PEP involves multiple aspects, including assessment of patient related factors, administration of pharmacological agents and suitable procedural techniques. This article collected the clinical practices and recommendations mentioned in the relevant guidelines from the American Society for Gastrointestinal Endoscopy, the European Society of Gastrointestinal Endoscopy, the Japanese Society of Gastroenterology, and the Taiwan Pancreas Society. In addition, we have cited the latest research literatures for reference in attempt to reduce the incidence of PEP and promote a patient safety medical environment.