Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis: An Updated Review of Current Preventive Strategies

Figures & data

Table 1 Revised Atlanta Criteria for Severity of PEP

Severity Grades	Criteria^Citation1
Mild	No organ failure No local or systemic complications
Moderate	Transient organ failure (resolves within 48 hours) and/or Local or systemic complications without persistent organ failure
Severe	Persistent organ failure (duration of >48 hours) Single organ failure Multiple organ failure
Local complications: Pancreatic/peripancreatic necrosis (sterile or infected), peripancreatic fluid collections, pseudocyst, walled-off necrosis (sterile or infected)

Table 2 Risk Factors for Post-ERCP Pancreatitis

	Risk Factors for PEP^Citation5^–^Citation8
Procedure-related
Definite	Difficult or prolonged cannulation Pancreatic duct injection Pancreatic guidewire passages
Likely	Pancreatic sphincterotomy Precut sphincterotomy Biliary balloon sphincter dilation Intraductal ultrasound Failure to clear bile duct stones
Patient-related
Definite	Female sex Previous attacks of PEP Previous attacks of pancreatitis Sphincter of Oddi dysfunction
Likely	Younger age (<55) Normal serum bilirubin End-stage renal disease Nondilated extrahepatic bile duct Absence of chronic pancreatitis

Banks PA, Bollen TL, Dervenis C, et al. Classification of acute pancreatitis–2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2013;62(1):102–111. doi:10.1136/gutjnl-2012-302779

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Dumonceau JM, Kapral C, Aabakken L, et al. ERCP-related adverse events: European Society of Gastrointestinal Endoscopy (ESGE) guideline. Endoscopy. 2020;52(2):127–149. doi:10.1055/a-1075-4080

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