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 Gastrointest Endosc. Apr 16, 2026; 18(4): 117983
Published online Apr 16, 2026. doi: 10.4253/wjge.v18.i4.117983
Published online Apr 16, 2026. doi: 10.4253/wjge.v18.i4.117983
Non-endoscopic strategies to prevent post-endoscopic retrograde cholangiopancreatography pancreatitis
Yasir M Khayyat, Department of Medicine, Faculty of Medicine, Umm AL-Qura University, Makkah 8156-24381, Saudi Arabia
Author contributions: Khayyat YM performed literature review, collection, initial drafting, and final review of the manuscript.
Conflict-of-interest statement: The author declared that there was no conflict of interest to disclose.
Corresponding author: Yasir M Khayyat, FACG, FACP, FRCP (C), Professor, Department of Medicine, Faculty of Medicine, Umm AL-Qura University, AlAwali District, Makkah 8156-24381, Saudi Arabia. ymkhayyat@uqu.edu.sa
Received: December 22, 2025
Revised: January 14, 2026
Accepted: February 4, 2026
Published online: April 16, 2026
Processing time: 113 Days and 22.6 Hours
Revised: January 14, 2026
Accepted: February 4, 2026
Published online: April 16, 2026
Processing time: 113 Days and 22.6 Hours
Core Tip
Core Tip: Prophylaxis for post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP) should be stratified according to patient risk. Rectal non-steroidal anti-inflammatory drugs (NSAIDs) are the foundational, evidence-based intervention recommended for all patients. In high-risk individuals, the combination of rectal NSAIDs with aggressive intravenous lactated Ringer’s hydration is beneficial, particularly for reducing moderate-to-severe PEP. Prophylactic stenting of the pancreatic duct remains a key endoscopic strategy in high-risk cases. A universal, risk-adapted approach utilizing these non-endoscopic (medication and hydration) and endoscopic (stenting) measures is essential for effective prevention.