{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T12:00:03Z","timestamp":1793102403668,"version":"4.5.0"},"reference-count":26,"publisher":"Wiley","issue":"6-7","license":[{"start":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T00:00:00Z","timestamp":1693353600000},"content-version":"vor","delay-in-days":90,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Digest Diseases"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To systematically evaluate the patient and procedural risk factors for post\u2010endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) among patients receiving rectal indomethacin.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data from a randomized controlled trial (RCT) of high\u2010risk patients undergoing ERCP who received rectal indomethacin with or without topical epinephrine was evaluated. PEP was defined based on the consensus criteria. Pancreatic stenting was excluded to avoid confounding results with the role of epinephrine spray. Multivariable logistic regression analysis was used to identify patient and procedural risk factors for PEP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 960 patients enrolled in the RCT, the PEP incidence was 6.4%. An increased risk of PEP was seen with age\u2009&lt;50\u2009years and female gender (odds ratio [OR] 2.40, 95% confidence interval [CI] 1.35\u20134.26), malignant biliary stricture(s) (OR 3.51, 95% CI 1.52\u20138.10), &gt;2 guidewire passes into the pancreatic duct (PD) (OR 2.84, 95% CI 1.43\u20135.64), and pancreatic brush cytology (OR 6.37, 95% CI 1.10\u201336.90), whereas a decreased risk of PEP was seen with contrast\u2010 over guidewire\u2010assisted cannulation (OR 0.14, 95% CI 0.02\u20130.99) and the use of lactated Ringer's (LR) over other fluid types (OR 0.52, 95% CI 0.27\u20130.98). There was a significant trend between the number of guidewire passes into the PD and PEP risk (<jats:italic>P<\/jats:italic>\u2009=\u20090.002).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>More than two guidewire passes into the PD and pancreatic brush cytology increased while the use of LR decreased the risk of PEP among high\u2010risk patients receiving rectal indomethacin. Pancreatic stent placement and\/or LR should be considered in patients with &gt;2 guidewire passes into the PD.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1751-2980.13208","type":"journal-article","created":{"date-parts":[[2023,7,28]],"date-time":"2023-07-28T16:14:11Z","timestamp":1690560851000},"page":"427-433","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Frequent guidewire passage into the pancreatic duct is an independent risk factor for postendoscopic retrograde cholangiopancreatography (<scp>ERCP<\/scp>) pancreatitis (<scp>PEP<\/scp>) among high\u2010risk individuals: A post\u2010hoc analysis of a randomized controlled trial data"],"prefix":"10.1111","volume":"24","author":[{"given":"Mahesh K.","family":"Goenka","sequence":"first","affiliation":[{"name":"Institute of Gastrosciences and Liver Apollo Gleneagles Hospital  Kolkata India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8909-1951","authenticated-orcid":false,"given":"Venkata S.","family":"Akshintala","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine Johns Hopkins Medical Institutions  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayesha","family":"Kamal","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine Johns Hopkins Medical Institutions  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Furqan A.","family":"Bhullar","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine Johns Hopkins Medical Institutions  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikhil","family":"Bush","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine Johns Hopkins Medical Institutions  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijay","family":"Kumar","sequence":"additional","affiliation":[{"name":"Institute of Gastrosciences and Liver Apollo Gleneagles Hospital  Kolkata India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madhurima","family":"Chakraborty","sequence":"additional","affiliation":[{"name":"Institute of Gastrosciences and Liver Apollo Gleneagles Hospital  Kolkata India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merve","family":"Gurakar","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine Johns Hopkins Medical Institutions  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sundeep","family":"Lakhtakia","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Asian Institute of Gastroenterology  Hyderabad India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rupjyoti","family":"Talukdar","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Asian Institute of Gastroenterology  Hyderabad India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guru","family":"Trikudanathan","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition University of Minnesota  Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mouen A.","family":"Khashab","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine Johns Hopkins Medical Institutions  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony N.","family":"Kalloo","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine Johns Hopkins Medical Institutions  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. Nageshwar","family":"Reddy","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Asian Institute of Gastroenterology  Hyderabad India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saroj K.","family":"Sinha","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Postgraduate Institute of Medical Education &amp; Research  Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vikesh K.","family":"Singh","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine Johns Hopkins Medical Institutions  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rakesh","family":"Kochhar","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Postgraduate Institute of Medical Education &amp; Research  Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,8,30]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0043-102402"},{"key":"e_1_2_8_3_1","unstructured":"Agency for Healthcare Research and Quality.Healthcare Cost and Utilization Project 2020. Accessed April 7 2020.https:\/\/hcupnet.ahrq.gov\/"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2007.01279.x"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2010.136"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1067\/mge.2001.117550"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/2047\u2010783X\u201019\u201026"},{"issue":"4","key":"e_1_2_8_8_1","first-page":"357","article-title":"Temporal trends and mortality of post\u2010ERCP pancreatitis in the United States: a nationwide analysis","volume":"53","author":"Mutneja HR","year":"2020","journal-title":"Endoscopy"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000000623"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1111103"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000000049"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.12908"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5107(91)70740-2"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.12591"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0032-1326640"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD010571.pub2"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5107(03)02530-6"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2014.06.005"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2008.5"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0034-1377875"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2014.07.033"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2017.05.008"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2016.268"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pan.2019.07.046"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1055\/a-1149-1359"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12262-015-1365-x"}],"container-title":["Journal of Digestive Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1751-2980.13208","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,15]],"date-time":"2023-09-15T02:09:00Z","timestamp":1694743740000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1751-2980.13208"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6]]},"references-count":26,"journal-issue":{"issue":"6-7","published-print":{"date-parts":[[2023,6]]}},"alternative-id":["10.1111\/1751-2980.13208"],"URL":"https:\/\/doi.org\/10.1111\/1751-2980.13208","archive":["Portico"],"relation":{},"ISSN":["1751-2972","1751-2980"],"issn-type":[{"value":"1751-2972","type":"print"},{"value":"1751-2980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6]]},"assertion":[{"value":"2022-07-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-07-25","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-08-30","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}