Post-ERCP Pancreatitis Prevalence, Prediction and Prevention

Abstract

Post-ERCP pancreatitis is the most common and clinically significant complication of endoscopic retrograde cholangiopancreatography (ERCP). Despite advances in technique and guideline-based prevention, it remains a major cause of morbidity, prolonged hospitalization, and healthcare costs. This dissertation shows that post-ERCP pancreatitis occurs in approximately one in ten patients and in nearly one in seven high-risk patients. Severe disease and mortality are uncommon, yet carry substantial clinical impact. The findings demonstrate that the risk of post-ERCP pancreatitis varies widely between patients and procedures and that preventive strategies are not equally effective for everyone. Should all patients therefore receive the same prophylaxis? Probably not. This work shows that a risk-stratified and combined preventive approach results in fewer complications and avoids unnecessary interventions. As in many areas of medicine, individualized care proves superior to a one-size-fits-all strategy.