Plavsic I, Žitinić I, Mikolasevic I, Poropat G, Hauser G. Endoscopic retrograde cholangiopancreatography-induced and non-endoscopic retrograde cholangiopancreatography-induced acute pancreatitis: Two distinct clinical and immunological entities? World J Gastrointest Endosc 2018; 10(10): 259-266 [PMID: 30364685 DOI: 10.4253/wjge.v10.i10.259]
Corresponding Author of This Article
Goran Hauser, MD, PhD, Research Assistant Professor, Department of Internal Medicine, Division of Gastroenterology, Clinical Hospital Centre, Medical Faculty, Faculty of health Studies, University of Rijeka, Kresimirova 42, Rijeka 51000, Croatia. goran.hauser@medri.uniri.hr
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Endosc. Oct 16, 2018; 10(10): 259-266 Published online Oct 16, 2018. doi: 10.4253/wjge.v10.i10.259
Endoscopic retrograde cholangiopancreatography-induced and non-endoscopic retrograde cholangiopancreatography-induced acute pancreatitis: Two distinct clinical and immunological entities?
Ivana Plavsic, Ivana Žitinić, Ivana Mikolasevic, Goran Poropat, Goran Hauser
Ivana Plavsic, Department of Anesthesiology and Critical care medicine, Clinical Hospital Centre, Medical Faculty, University of Rijeka, Rijeka 51000, Croatia
Ivana Žitinić, Department of Emergency Medicine, Clinical Hospital Centre, Rijeka 51000, Croatia
Ivana Mikolasevic, Goran Poropat, Department of Internal Medicine, Division of Gastroenterology, Clinical Hospital Centre, Medical Faculty, University of Rijeka, Rijeka 51000, Croatia
Goran Hauser, Department of Internal Medicine, Division of Gastroenterology, Clinical Hospital Centre, Medical Faculty, Faculty of health Studies, University of Rijeka, Rijeka 51000, Croatia
Author contributions: Plavsic I and Hauser G designed and conduct research and are the guarantors of this work; Plavsic I, Hauser G, Žitinić I, Mikolasevic I, Poropat G contributed to the discussion and reviewed/edited the manuscript; Plavsic I, Poropat G and Hauser G analysed collected data; Plavsic I, Hauser G and Žitinić I wrote the paper.
Supported byan education grant from Unicersity of Rijeka, No. 963./2018.
Conflict-of-interest statement: No potential conflicts of interest relevant to this article were reported.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Goran Hauser, MD, PhD, Research Assistant Professor, Department of Internal Medicine, Division of Gastroenterology, Clinical Hospital Centre, Medical Faculty, Faculty of health Studies, University of Rijeka, Kresimirova 42, Rijeka 51000, Croatia. goran.hauser@medri.uniri.hr
Telephone: +385-51-568122 Fax: +385-51-658386
Received: May 18, 2018 Peer-review started: May 18, 2018 First decision: June 4, 2018 Revised: June 10, 2018 Accepted: August 1, 2018 Article in press: August 1, 2018 Published online: October 16, 2018 Processing time: 151 Days and 15.8 Hours
Abstract
Acute pancreatitis (AP) is common gastrointestinal disease of varied aetiology. The most common cause of AP is gallstones, followed by alcohol abuse as an independent risk factor. With the increased need for invasive techniques to treat pancreatic and bile duct pathologies such as endoscopic retrograde cholangiopancreatography (ERCP), AP has emerged as the most frequent complication. While severe AP following ERCP is rare (0.5%), if it does develop it has a greater severity index compared to non-ERCP AP. Development of a mild form of AP after ERCP is not considered a clinically relevant condition. Differences in the clinical presentation and prognosis of the mild and severe forms have been found between non-ERCP AP and post-endoscopic pancreatitis (PEP). It has been proposed that AP and PEP may also have different immunological responses to the initial injury. In this review, we summarise the literature on clinical and inflammatory processes in PEP vs non-ERCP AP.
Core tip: Acute pancreatitis (AP) is the most frequent complication after endoscopic retrograde cholangiopancreatography (ERCP) and although low prevalence is found, if it develops it has greater severity index compared to non-ERCP AP. The differences in factors influencing appearance, clinical presentation and prognosis of ERCP induced and non ERCP induced AP were found, lead to opinion that mechanism by which they induce inflammation, may also be different. It would be of great importance to find immunological components that can distinguish patients with tendency to develop severe AP from patients with mild form, especially in ERCP induced AP where organ failure occurs half time earlier.
