TY - JOUR
T1 - Increased Use of Prophylactic Measures in Preventing Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis
AU - Sperna Weiland, Christina J.
AU - Engels, Megan M. L.
AU - Poen, Alexander C.
AU - Bhalla, Abha
AU - Venneman, Niels G.
AU - van Hooft, Jeanin E.
AU - Bruno, Marco J.
AU - Verdonk, Robert C.
AU - Dutch Pancreatitis Study Group
AU - Fockens, Paul
AU - Drenth, Joost P. H.
AU - van Geenen, Erwin J. M.
N1 - Funding Information: The study was funded by the Netherlands Organization for Health Research and Development (ZonMw, Grant No. 837001506) and the Radboud University Medical Center. ZonMw had no role in study design, data collection, data analysis, data interpretation, or preparation of the report. The corresponding author has full access to all the data in the study and bears final responsibility for the decision to submit for publication. Funding Information: Christina J. Sperna Weiland, Megan M.L. Engels, Robert C. Verdonk, Alexander C. Poen, Abha Bhalla, and Niels G. Venneman do not have potential conflicts of interest or disclosures to report. Jeanin E. van Hooft has received research support from Cook Medical and received consultancy fees from Medtronic, Cook Medical, and Boston Scientific. Marco J. Bruno has received research support from Boston Scientific, Cook Medical, Pentax Medical, InterScope, and 3 M and acted as a consultant for Boston Scientific, Cook Medical, and Pentax Medical; Paul Fockens has received consultancy fees from Cook Medical, Olympus, and Ethicon Endo-Surgery. Joost P.H. Drenth has received research support from Gilead to support Hepatitis C elimination in The Netherlands. Erwin J.M. van Geenen has received research support from Mylan and Olympus and acted as a consultant for MTW-Endoskopie. Publisher Copyright: © 2021, The Author(s).
PY - 2021/12
Y1 - 2021/12
N2 - Background: Nonsteroidal anti-inflammatory drugs (NSAIDs), pancreatic duct stenting, and intensive intravenous hydration have been proven to prevent post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis. Trial participation and guideline changes demanded an assessment of the clinical practice of post-ERCP pancreatitis prophylaxis. Aims: The surveys aim to identify points of improvement to inform and educate ERCPists about current evidence-based practice. Methods: Two anonymous surveys were conducted among Dutch gastroenterologists in 2013 (n = 408) and 2020 (n = 575) for longitudinal views and attitudes pertaining to post-ERCP pancreatitis prophylaxis and recognition of post-ERCP pancreatitis risk factors. Results: In 2013 and 2020, respectively, 121 and 109 ERCPists responded. In the 2013 survey, 98% of them utilized NSAID prophylaxis and 62% pancreatic duct stent prophylaxis in specific cases. In the 2020 survey, the use of NSAIDs (100%), pancreatic duct stents (78%), and intensive intravenous hydration (33%) increased among ERCPists. NSAID prophylaxis was the preferred prophylactic measure for all risk factors in the 2020 survey, except for ampullectomy, pancreatic duct contrast injection, and pancreatic duct cannulation, for which NSAID prophylaxis and pancreatic duct stent combined was equally favored or preferred. Conclusion: Rectal NSAIDs are the most applied post-ERCP pancreatitis prophylaxis in the Netherlands, followed by pancreatic duct stents and intensive intravenous hydration. Additionally, there is reason to believe that recent guideline updates and active research participation have led to increased prophylaxis implementation.
AB - Background: Nonsteroidal anti-inflammatory drugs (NSAIDs), pancreatic duct stenting, and intensive intravenous hydration have been proven to prevent post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis. Trial participation and guideline changes demanded an assessment of the clinical practice of post-ERCP pancreatitis prophylaxis. Aims: The surveys aim to identify points of improvement to inform and educate ERCPists about current evidence-based practice. Methods: Two anonymous surveys were conducted among Dutch gastroenterologists in 2013 (n = 408) and 2020 (n = 575) for longitudinal views and attitudes pertaining to post-ERCP pancreatitis prophylaxis and recognition of post-ERCP pancreatitis risk factors. Results: In 2013 and 2020, respectively, 121 and 109 ERCPists responded. In the 2013 survey, 98% of them utilized NSAID prophylaxis and 62% pancreatic duct stent prophylaxis in specific cases. In the 2020 survey, the use of NSAIDs (100%), pancreatic duct stents (78%), and intensive intravenous hydration (33%) increased among ERCPists. NSAID prophylaxis was the preferred prophylactic measure for all risk factors in the 2020 survey, except for ampullectomy, pancreatic duct contrast injection, and pancreatic duct cannulation, for which NSAID prophylaxis and pancreatic duct stent combined was equally favored or preferred. Conclusion: Rectal NSAIDs are the most applied post-ERCP pancreatitis prophylaxis in the Netherlands, followed by pancreatic duct stents and intensive intravenous hydration. Additionally, there is reason to believe that recent guideline updates and active research participation have led to increased prophylaxis implementation.
KW - ERCP
KW - Endoscopic retrograde cholangiopancreatography
KW - Gastroenterologists
KW - Infusions
KW - Intravenous
KW - Nonsteroidal anti-inflammatory agents
KW - Pancreatic ducts
KW - Pancreatitis
KW - Risk factors
KW - Risk reduction behavior
KW - Surveys and questionnaires
UR - http://www.scopus.com/inward/record.url?scp=85101766349&partnerID=8YFLogxK
U2 - https://doi.org/10.1007/s10620-020-06796-0
DO - https://doi.org/10.1007/s10620-020-06796-0
M3 - Article
C2 - 33630216
SN - 0163-2116
VL - 66
SP - 4457
EP - 4466
JO - Digestive Diseases and Sciences
JF - Digestive Diseases and Sciences
IS - 12
ER -