ArticleiGIE : innovation, investigation and insights2026
Post-endoscopic retrograde cholangiopancreatography pancreatitis prophylaxis: a stratified assessment for evaluation of risk approach.
Article in iGIE : innovation, investigation and insights, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background and Aims: The risk of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) is influenced by patient and procedure-related factors. Strategies to decrease PEP are of great importance. This study aimed to determine if PEP prophylaxis (PEPX) could be avoided in patients in whom high-risk procedure-related factors are avoided as guided by a Stratified Assessment for Evaluation of Risk (SAFER) approach. SAFER is a dynamic process whereby procedure-related factors direct PEPX strategies. Methods: A prospective database of consecutive ERCPs was analyzed. Data regarding demographics, procedure indications, previous ERCP attempts, cannulation techniques, PEPX received, and adverse events were collected. Each ERCP was classified for PEP risk pre- and post-ERCP based on patient factors, procedure indications, findings, and techniques. PEP incidence was assessed with or without PEPX after stratifying risk using a SAFER approach. Results: From a cohort of 3006 procedures, PEP incidence without any PEPX in all patients with low post-ERCP risk (n = 2096) was 0.2%. Independent of PEPX, there was no significant difference in the incidence of PEP between procedures with both low pre- and post-ERCP risk and those with high pre-ERCP risk but low post-ERCP risk. Conclusions: To influence PEPX decisions, procedure-related factors may be more important than patient-related PEP risk factors. A SAFER approach suggests that low-risk post-ERCP patients do not need PEPX, although further prospective studies are needed.
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Registered trials
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