Risk factors for post-ERCP pancreatitis

Procedure-related factors	Patient-related factors
Difficult cannulation of the bile duct* Repeated guidewire cannulation into the main pancreatic duct Multiple injections of contrast material or other fluid into the main pancreatic duct Balloon dilation of an intact biliary sphincter Pancreatic sphincterotomy Endoscopic snare papillectomy	Younger age (<55 years) Female sex History of pancreatitis related to ERCP or any cause Suspected type I or II sphincter of Oddi dysfunction

Refer to UpToDate content on preventing post-ERCP pancreatitis.

ERCP: endoscopic retrograde cholangiopancreatography.

* We generally limit the number of cannulation attempts to ≤5 attempts (or maximum duration of 5 minutes) because trauma to the biliary orifice has been associated with post-ERCP pancreatitis.

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Risk factors for post-ERCP pancreatitis