title: Endoscopic retrograde cholangiopancreatography (ERCP)-related adverse events: post-ERCP pancreatitis.
abstract: Post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP) is the most common complication of endoscopic retrograde cholangiopancreatography (ERCP), and not uncommonly is the reason behind ERCP-related lawsuits. Patients at high risk for PEP include young women with abdominal pain, normal liver tests, and unremarkable imaging. Procedure-related factors include traumatic and persistent cannulation attempts, multiple injections of the pancreatic duct, pancreatic sphincterotomy, and, possibly, use of precut sphincterotomy. Aggressive hydration, use of rectal indomethacin, and prophylactic pancreatic stenting can diminish the risk (and likely severity) of PEP. Though hugely beneficial, these measures do not supersede careful patient selection and technique.
authors.affiliation: Section of Digestive Diseases, Department of Internal Medicine, Yale University School of Medicine, 333 Cedar Street, 1080 LMP, New Haven, CT 06520, USA.
authors.forename: Tarun
authors.initials: T
authors.lastname: Rustagi
authors.affiliation: Section of Digestive Diseases, Department of Internal Medicine, Yale University School of Medicine, 333 Cedar Street, 1080 LMP, New Haven, CT 06520, USA. Electronic address: priya.jamidar@yale.edu.
authors.forename: Priya A
authors.initials: PA
authors.lastname: Jamidar
mesh_terms: D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects*; D006801:Humans; D010195:Pancreatitis / Q000209:etiology* / Q000517:prevention & control; D012307:Risk Factors
keywords: Cannulation; Indomethacin; Manometry; Pancreatic stents; Pancreatitis; Precut; Sphincter of Oddi dysfunction; Sphincterotomy