Letter to the Editor: Omission of key predictors of sepsis undermines the validity of risk modelling for post-endoscopic retrograde cholangiopancreatography biliary infection

doi:10.3748/wjg.116606

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastroenterol. Aug 14, 2026; 32(30): 116606
Published online Aug 14, 2026. doi: 10.3748/wjg.116606

Letter to the Editor: Omission of key predictors of sepsis undermines the validity of risk modelling for post-endoscopic retrograde cholangiopancreatography biliary infection

Omar Elshaarawy, Jayapal Ramesh

Omar Elshaarawy, Jayapal Ramesh, Department of Gastroenterology, University of Liverpool Hospitals, Liverpool L7 8YE, Merseyside, United Kingdom

Jayapal Ramesh, Centre for Advanced Endoscopy Research and Education, Orlando Health Digestive Health Institute, Orlando, FL 32806, United States

Co-corresponding authors: Omar Elshaarawy and Jayapal Ramesh.

Author contributions: Elshaarawy O and Ramesh J conceived and designed the manuscript; Elshaarawy O drafted the manuscript; Ramesh J critically revised the manuscript for important intellectual content.

AI contribution statement: Grammarly for language polishing of Abstract. The authors confirm that no AI tools were used for study design, analysis, image generation or data interpretation. Grammarly was only used for language polishing of the abstract to ensure clarity.

Conflict-of-interest statement: The authors declare that they have no conflict of interest.

Corresponding author: Omar Elshaarawy, MD, Doctor, Department of Gastroenterology, University of Liverpool Hospitals, Mount Vernon Street, Liverpool L7 8YE, Merseyside, United Kingdom. oelshaarawy@outlook.com

Received: November 17, 2025
Revised: January 18, 2026
Accepted: February 26, 2026
Published online: August 14, 2026
Processing time: 250 Days and 5.2 Hours

Core Tip

Core Tip: Post-endoscopic retrograde cholangiopancreatography biliary infection is a significant risk in malignant obstruction. Current risk models are incomplete, omitting critical factors like drainage adequacy (hepatic volume decompressed) and inflammatory biomarkers. Comprehensive models are essential for accurate postoperative biliary infection risk prediction and better clinical outcomes.