{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T16:28:59Z","timestamp":1793809739648,"version":"4.6.1"},"reference-count":35,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:00:00Z","timestamp":1775520000000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["DEN Open"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Post\u2010endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) is a well\u2010known complication. While most reported risk factors relate to treatment\u2010na\u00efve papillae, those in patients with post\u2010endoscopic sphincterotomy (post\u2010EST) papillae remain unclear. We aimed to identify risk factors for PEP in patients with a history of EST undergoing ERCP for biliary disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed 678 patients with prior EST who underwent ERCP between January 2017 and October 2023. PEP was diagnosed according to established criteria. Logistic regression analyses were performed to identify risk factors. To account for repeated ERCP sessions, additional analyses using cluster\u2010robust standard errors were conducted. Body mass index (BMI) was evaluated as both a continuous variable and according to World Health Organization categories. Prophylactic rectal diclofenac or intravenous nafamostat mesilate was administered at the operator's discretion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mean age was 75.4 years, and PEP occurred in 4.4%. Multivariate analysis identified female sex (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.016; odds ratio [OR] 2.97), low BMI (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.021; OR 2.94), and prolonged procedure time (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.0048; OR 4.29) as independent risk factors. Operator experience and prophylactic agents were not significantly associated with PEP. In analyses accounting for within\u2010patient correlation, BMI &lt;18.5\u00a0kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      remained significantly associated with PEP (OR 2.73;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.012), whereas associations with sex and procedure duration were attenuated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Low BMI is a consistent risk factor for PEP in patients with post\u2010EST papillae. The effectiveness of pharmacologic prophylaxis may differ from that in treatment\u2010na\u00efve papillae and warrants prospective evaluation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>N\/A.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/deo2.70322","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T12:14:19Z","timestamp":1775564059000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk Factors for Post\u2010Endoscopic Retrograde Cholangiopancreatography Pancreatitis in Patients With Post\u2010Endoscopic Sphincterotomy Papillae"],"prefix":"10.1002","volume":"6","author":[{"given":"Shuhei","family":"Shibata","sequence":"first","affiliation":[{"name":"Department of Gastroenterology Chiba Kaihin Municipal Hospital  Chiba Japan"},{"name":"Department of Gastroenterology Chiba University Hospital  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katsunobu","family":"Tawada","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Chiba Kaihin Municipal Hospital  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideyuki","family":"Takashiro","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Chiba Kaihin Municipal Hospital  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinichi","family":"Tazawa","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Chiba Kaihin Municipal Hospital  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masatoshi","family":"Usui","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Chiba Kaihin Municipal Hospital  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiromasa","family":"Nomoto","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Chiba Kaihin Municipal Hospital  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirofumi","family":"Saito","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Chiba Kaihin Municipal Hospital  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,7]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2003-42614"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surge.2014.11.005"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1067\/mge.2001.117550"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-966723"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2008.5"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.15135"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.14225"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.15004"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5085(03)00384-6"},{"key":"e_1_2_10_11_1","first-page":"1632","article-title":"Rectal Administration of NSAIDs in the Prevention of Post\u2010ERCP Pancreatitis: A Complementary Meta\u2010analysis","volume":"57","author":"Zheng M. 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