Post-ERCP severe acute pancreatitis:a clinical analysis of 6 cases        TONG Zhi-hui，LI Wei-qin，YU Wen-kui，et al．Department of General Surgery, Nanjing General Hospital of Nanjing Military Command, Medical School of Nanjing University，Nanjing 210002，China
Corresponding  author：LI Wei-qin，E-mail：antol@sohu.com
Abstract    Objective    To analyze the prevention and therapy of post-ERCP pancreatitis. Methods    The clinical characteristics of 6 post-ERCP pancreatitis patients admitted between April 2006 and August 2009 at Nanjing General Hospital of Nanjing Military Command were summarized by retrospective analysis, and the clinical procedures and outcomes were analyzed. Results    ERCP was performed for different causes. One patient was failed to cannulation repeatedly, 2 patients had pancreatic tube injection, 3 patients had Oddi-sphincterotomy, none of them had balloon dilatation of the intact biliary sphincter or pancreatic sphincterotomy. No prophylaxis medication was administered pre/post-ERCP, and no pancreatic tube stand was performed. Patients had diagnosis of SAP in 8 to 48 hours after ERCP. In early stage , 4 patients complicated with ALI, 1 patient complicated with ARDS, while 1 patient complicated with both ARDS and ARF. In the following stage, 5 patients had pancreatic debridement because of infection of pancreatic necrosis. One patient died of PEP.  Conclusion    Indications of ERCP should be strictly controlled. Evaluation of risk factors before ERCP, avoidance of high-risk performance during the process and early diagnosis of post-ERCP pancreatitis is of invaluable importance to prevent and treat PEP.