Post-ERCP Pancreatitis and Prevention

Pancreatitis following endoscopic retrograde cholangiopancreatography (PEP) represents the most common adverse outcome of the procedure, affecting 2–15% of individuals, leading to significant morbidity, occasional fatalities, and a rise in healthcare costs. From 2011 to 2017, there was a 15.3% surge in hospital admissions due to PEP, primarily because ERCP is increasingly utilized for complex therapeutic purposes rather than diagnostic ones. Progress in understanding PEP’s pathophysiology, better selection of patients, enhancements in the techniques used during the procedure, and the introduction of more effective measures for PEP prevention have been achieved. This chapter is dedicated to presenting a strategy grounded in scientific evidence for preventing PEP, along with a discussion on the continuous efforts to decrease its incidence.