Brief Articles
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World J Gastrointest Endosc. Dec 16, 2010; 2(12): 397-403
Published online Dec 16, 2010. doi: 10.4253/wjge.v2.i12.397
Dietary approaches following endoscopic retrograde cholangiopancreatography: A survey of selected endoscopists
Lincoln EVVC Ferreira, Mark D Topazian, William S Harmsen, Alan R Zinsmeister, Todd H Baron
Lincoln EVVC Ferreira, Department of Medicine, Digestive Endoscopy Unit Hospital Universitario da Universidade Federal de Juiz de For a, Juiz de Fora, MG 36036247, Brasil
Mark D Topazian, Todd H Baron, Department of Medicine, Division of Gastroenterology and Hepatology, Rochester, MN 55905, United States
William S Harmsen, Alan R Zinsmeister, Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN 55905, United States
Author contributions: Ferreira LEVVC, Baron TH and Topazian MD were responsible for the idea, the development of the survey and the manuscript; and Harmsen WS and Zinsmeister AR were responsible for the formatting of the survey and statistical analysis.
Correspondence to: Todd H Baron, MD, Department of Medicine, Division of Gastroenterology and Hepatology, 200 1st Street SW, Rochester, MN 55905, United States.
Telephone: +1-507-2842174
Received: July 14, 2010
Revised: November 25, 2010
Accepted: December 2, 2010
Published online: December 16, 2010

AIM: To describe the dietary recommendations of experienced endoscopists for patients who have undergone endoscopic retrograde cholangiopancreatography (ERCP) and the factors that influence these recommendations.

METHODS: Selected U.S. endoscopists with ERCP experience were surveyed by e-mail. A questionnaire with three hypothetical ERCP cases of patients at low, medium and high risk for development of post-ERCP pancreatitis (PEP) was shown. For each scenario, respondents were asked to recommend a post-procedure diet and time to first oral intake. Respondents were also asked about the effect of various clinical factors on their recommendations, including risk of PEP.

RESULTS: 97/187 selected ASGE members (51.9%) responded. When risk of PEP was either low, medium or high, 53%, 88% and 96% recommended a diet of clear liquids/NPO respectively, and 2%, 5% and 18% recommended delaying first oral intake until the following day. About 88% of respondents gave the same type of diet to patients at high as those with moderate-risk of PEP (P = 0.04). However, 37% and 43% of respondents gave different types of diet to patients at low vs moderate-risk and low-risk vs high-risk of PEP respectively (P < 0.001). No statistically significant associations were found regarding the effect of other clinical factors or respondent demographics.

CONCLUSION: Most experienced endoscopists limit diet to NPO/clear liquids after ERCP for patients at high or moderate risk of post-ERCP pancreatitis. About half allow a low-fat or regular diet in patients at low risk.

Keywords: Cholangiopancreatography, Endoscopic retrograde, Diet, Pancreatitis, Survey, Postoperative care