Risk factors and prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis

Table 1 Risk factors for post-endoscopic retrograde cholangiopancreatography pancreatitis

Risk factor	Category	Description
Female sex	Patient-related	Higher risk due to hormonal influences on sphincter contractility and pancreatic enzyme activation
Younger age	Patient-related	Increased susceptibility is possibly due to hormonal influences and pancreatic enzyme activation
Sphincter of Oddi dysfunction	Patient-related	Independent predictor of PEP
Previous pancreatitis	Patient-related	A history of pancreatitis or prior PEP increases the risk
Low body mass index	Patient-related	Associated with an increased risk of PEP
Difficult cannulation	Procedure-related	Prolonged or difficult cannulation increases risk due to trauma and pressure
Prolonged cannulation time	Procedure-related	Increased procedure time increases the risk of PEP
Pancreatic duct injection or guidewire cannulation	Procedure-related	These techniques increase hydrostatic pressure and injury to pancreatic tissue
Precut sphincterotomy	Procedure-related	Risk, depending on technique and timing -can elevate or reduce risk
Endoscopist experience	Procedure-related	Higher procedure volumes correlate with lower complication rates

PEP: Post-endoscopic retrograde cholangiopancreatography pancreatitis.