Procedure and Patient-Related Risk Factors for Post-ERCP Pancreatitis Associated with Prophylactic Pancreatic Stent and Rectal Indomethacin

Background: Pancreatitis is one of the most crucial complications following endoscopic retrograde cholangiopancreatography (ERCP). The purpose of the current study was to investigate a potential procedure and patient-related risk factors for post-ERCP pancreatitis (PEP) in two groups: prophylactic pancreatic stent and rectal indomethacin.Methods: Two different prophylactic modalities were planned and complications were assessed based on defined inclusion criteria. In this study, the patients were evaluated for the procedure and patient-related risk factors in post-ERCP pancreatitis in the recipient groups of the prophylactic pancreatic stent or rectal indomethacin.Results: Pancreatitis was confirmed in 27 of all 175 selected patients after ERCP. By univariate analysis, two variables were significant with the development of PEP. Regarding the patient-related risk factors, unique subjects with common bile duct(CBD) dilated 10mm were more exposed to an increased chance of PEP (p=0. 015); meanwhile, other factors didn’t correlate with the increased possibility of PEP in both groups. The only procedure-related risk factor for PEP was deep cannulation of the pancreatic duct in both groups during the procedure with an incremental significant incidence of pancreatitis (p=0.005). Prophylactic pancreatic stent and rectal indomethacin showed no effects on reducing post ERCP pancreatitis. Additionally, there was no significant difference between these two strategies in the rate of PEP.Conclusion: Prophylactic pancreatic duct stents and administration of rectal indomethacin cannot have particular methods for reducing the occurrence of PEP. The increase in time of deep cannulation and the presence of CBD dilation <10mm could be considered as important risk factors.