以積極乳酸林格氏輸液預防內視鏡逆行性膽胰管攝影術後胰臟炎發生之照護

Endoscopic retrograde cholangiopancreatography (ERCP) is a first-line therapy for common bile duct stones; however, post-ERCP pancreatitis is one of the procedure-related complication. This 63-year-old man presented with abdominal pain and jaundice, and was diagnosed as common bile duct stone with common bile duct dilatation. Subsequently, the patient was admitted for receiving ERCP with stone retrieval. After ERCP, Lactate Ringer's hydration as a standard prescription reduced the risk of post-ERCP pancreatitis. However, the dosage of Lactated Ringer's hydration for preventing post-ERCP remained controversial. Therefore, it is needed to perform evidence-based appraisal to investigate the adequate dosage of Lactated Ringer's hydration after ERCP. The results showed that aggressive Lactated Ringer's hydration as 3 c.c/kg/h could prevent post-ERCP pancreatitis. We applied aggressive Lactated Ringer's hydration to clinical practice after we discussed with the medical team and there was no post-ERCP pancreatitis occurred. However, there were three literatures reviewed and we provided aggressive Lactated Ringer therapy to a patient without severe comorbidities. Our experience could provide healthcare providers to provide aggressive Lactated Ringer hydration with cautions based on patients' clinical conditions in order to prevent post-ERCP pancreatitis.