{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T17:20:00Z","timestamp":1791048000508,"version":"4.1.0"},"reference-count":36,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:00:00Z","timestamp":1787616000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:00:00Z","timestamp":1787616000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100003710","name":"Korea Health Industry Development Institute","doi-asserted-by":"publisher","award":["RS\u20102024\u201000435385"],"award-info":[{"award-number":["RS\u20102024\u201000435385"]}],"id":[{"id":"10.13039\/501100003710","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100014188","name":"Ministry of Science and ICT, South Korea","doi-asserted-by":"publisher","award":["RS\u20102023\u201000273237"],"award-info":[{"award-number":["RS\u20102023\u201000273237"]}],"id":[{"id":"10.13039\/501100014188","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005006","name":"Asan Institute for Life Sciences, Asan Medical Center","doi-asserted-by":"publisher","award":["2023IT0008"],"award-info":[{"award-number":["2023IT0008"]}],"id":[{"id":"10.13039\/501100005006","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["UEG Journal"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Aggressive peri\u2010procedural intravenous fluid (IVF) therapy with lactated Ringer's solution (LR) reduces the risk of post\u2010ERCP pancreatitis (PEP), but the standard 8\u2010h protocol is impractical in outpatient settings and the optimal fluid type remains uncertain. We compared LR with an acetate\u2010buffered balanced crystalloid (AC) using a symptom\u2010guided 4\u2010h aggressive IVF protocol.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multicentre, double\u2010blind, randomized superiority trial was conducted at three academic hospitals in Korea where rectal NSAIDs are unavailable. Adults with native papillae and moderate\u2010to\u2010high PEP risk were randomized to receive LR or AC. The IVF protocol comprised 10\u00a0mL\/kg boluses before and after ERCP, followed by 3\u00a0mL\/kg\/h for 4\u00a0hours and extended to 8\u00a0hours if abdominal pain developed or worsened. The primary outcome was PEP incidence; secondary outcomes included early post\u2010ERCP pain and adverse events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 813 patients (404 LR, 409 AC), PEP occurred in 12.4% of the LR group and 11.5% of the AC group (relative risk [RR] 0.93; 95% CI, 0.64\u20131.35;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.70). Rates of mild (7.9% vs. 7.1%) and moderate (4.5% vs. 4.4%) PEP were similar, and no severe PEP or fluid overload occurred. Among the 68.3% of patients who remained asymptomatic at 4\u00a0hours and required only 4\u2010h IVF, PEP occurred in 7.4%, with no cases of severe PEP.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this superiority trial, acetate\u2010buffered crystalloid did not reduce PEP compared with lactated Ringer's solution, and no significant safety differences were observed between the two agents. Lactated Ringer's remains the recommended first\u2010line crystalloid for aggressive hydration when rectal NSAIDs are unavailable.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>ClinicalTrials.gov (NCT05832047)<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ueg2.70281","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T16:00:30Z","timestamp":1787673630000},"source":"Crossref","is-referenced-by-count":1,"title":["Acetate\u2010 Versus Lactate\u2010Buffered Crystalloids for Prevention of Post\u2010ERCP Pancreatitis in Patients Without Access to Rectal NSAIDs: A Multicentre Double\u2010Blind Randomized Trial"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8708-3280","authenticated-orcid":false,"given":"Woo Hyun","family":"Paik","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Seoul National University Hospital  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4502-7568","authenticated-orcid":false,"given":"Gunn","family":"Huh","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Asan Medical Center  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young Hoon","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Medicine Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2758-1370","authenticated-orcid":false,"given":"Jin Ho","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Seoul National University Hospital  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"In Rae","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Seoul National University Hospital  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2174-9726","authenticated-orcid":false,"given":"Sang Hyub","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Seoul National University Hospital  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji Kon","family":"Ryu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Seoul National University Hospital  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1916-7014","authenticated-orcid":false,"given":"Hwa Jung","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology and Biostatistics Asan Medical Center  Seoul 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