{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T16:16:17Z","timestamp":1791994577785,"version":"4.4.0"},"reference-count":28,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2024,2,17]],"date-time":"2024-02-17T00:00:00Z","timestamp":1708128000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>The prognostic factors associated with severe-to-fatal post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) remain unclear despite the extensive number of studies on PEP. In total, 3739 ERCP patients with biliary disease with an intact papilla and indicated for ERCP were prospectively enrolled at 36 centers from April 2017 to March 2018. Those with acute pancreatitis diagnosed before ERCP, altered gastrointestinal anatomy, and an American Society of Anesthesiologists (ASA) physical status &gt; 4 were excluded. Univariate and multivariate logistic regression analyses were performed on patient-related factors, operator-related factors, procedure-related factors, and preventive measures to identify potential prognostic factors for severe-to-fatal PEP. Multivariate analyses revealed pancreatic guidewire-assisted biliary cannulation (OR 13.59, 95% CI 4.21\u201343.83, p &lt; 0.001), post-ERCP non-steroidal anti-inflammatory drug (NSAID) administration (OR 11.54, 95% CI 3.83\u201334.81, p &lt; 0.001), and previous pancreatitis (OR 6.94, 95% CI 1.45\u201333.33, p = 0.015) as significant risk factors for severe-to-fatal PEP. Preventive measures included endoscopic biliary sphincterotomy (EST; OR 0.29, 95% CI, 0.11\u20130.79, p = 0.015) and prophylactic pancreatic stents (PPSs; OR 0.11, 95% CI, 0.01\u20130.87, p = 0.036). In biliary ERCP, pancreatic guidewire-assisted biliary cannulation, NSAID administration after ERCP, and previous pancreatitis were risk factors for severe-to-fatal PEP, whereas EST and PPS were significant preventive measures for severe-to-fatal PEP.<\/jats:p>","DOI":"10.3390\/jcm13041135","type":"journal-article","created":{"date-parts":[[2024,2,19]],"date-time":"2024-02-19T03:18:38Z","timestamp":1708312718000},"page":"1135","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Prognostic Factors for Severe-to-Fatal Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis: A Multicenter Prospective Cohort Study"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5680-4791","authenticated-orcid":false,"given":"Kazuya","family":"Matsumoto","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Nephrology, Faculty of Medicine, Tottori University, Tottori 683-8504, Japan"},{"name":"Irisawa Medical Clinic, Matsue 690-0025, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2520-9949","authenticated-orcid":false,"given":"Hisashi","family":"Noma","sequence":"additional","affiliation":[{"name":"Department of Data Science, The Institute of Statistical Mathematics, Tachikawa 190-8562, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0768-1801","authenticated-orcid":false,"given":"Koichi","family":"Fujita","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Yodogawa Christian Hospital, Osaka 533-0024, Japan"},{"name":"First Research Department, Medical Research Institute, Kitano Hospital, PIIF Tazuke-Kofukai, Osaka 530-8480, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Tomoda","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0310-0720","authenticated-orcid":false,"given":"Takumi","family":"Onoyama","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Nephrology, Faculty of Medicine, Tottori University, Tottori 683-8504, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3196-8551","authenticated-orcid":false,"given":"Keiji","family":"Hanada","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Onomichi General Hospital, Onomichi, Hiroshima 722-8508, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akihito","family":"Okazaki","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hiroshima Atomic Bomb Survivor Hospital, Hiroshima 730-0052, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken","family":"Hirao","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hiroshima City Hiroshima Citizens Hospital, Hiroshima 730-8518, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daisuke","family":"Goto","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Tottori Red Cross Hospital, Tottori 680-8517, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ichiro","family":"Moriyama","sequence":"additional","affiliation":[{"name":"Department of Hematology\/Oncology, Shimane University Hospital, Innovative Cancer Center, Izumo 693-8501, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshinori","family":"Kushiyama","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Matsue Red Cross Hospital, Matsue 690-8506, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7308-4311","authenticated-orcid":false,"given":"Mamoru","family":"Takenaka","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Kinki University, Osaka 589-8511, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toru","family":"Maruo","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Fukuoka University Chikushi Hospital, Fukuoka 814-0180, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hisakazu","family":"Matsumoto","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Japan Red Cross Hospital Wakayama Medical Center, Wakayama 640-8558, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7478-7649","authenticated-orcid":false,"given":"Masanori","family":"Asada","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Japan Red Cross Osaka Hospital, Osaka 543-8555, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4815-1831","authenticated-orcid":false,"given":"Hiroko","family":"Nebiki","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Osaka City General Hospital, Osaka 534-0021, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshihiro","family":"Katayama","sequence":"additional","affiliation":[{"name":"Help Center of Medical Research, Medical Research Institute, Kitano Hospital, PIIF Tazuke-Kofukai, Osaka 530-8480, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Kawamura","sequence":"additional","affiliation":[{"name":"Department of Preventive Services, School of Public Health, Graduate School of Medicine, Kyoto University, Kyoto 606-8303, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3047-7662","authenticated-orcid":false,"given":"Akira","family":"Kurita","sequence":"additional","affiliation":[{"name":"Kitano Hospital, Tazuke-Kofukai Medical Research Institute, Kyoto 530-8480, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshiharu","family":"Ueki","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Fukuoka University Chikushi Hospital, Fukuoka 814-0180, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Tsujimae","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Osaka Saiseikai 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Hepatology, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akira","family":"Mitoro","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Nara Medical University, Nara 634-8522, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hajime","family":"Isomoto","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Nephrology, Faculty of Medicine, Tottori University, Tottori 683-8504, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0683-0000","authenticated-orcid":false,"given":"Shujiro","family":"Yazumi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Medical Research Institute, Kitano Hospital, PIIF Tazuke-Kofukai, Osaka 530-8480, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirofumi","family":"Kawamoto","sequence":"additional","affiliation":[{"name":"General Internal Medicine 2, Kawasaki Medical School General Medical Center, Okayama 701-0192, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,2,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1781","DOI":"10.1111\/j.1572-0241.2007.01279.x","article-title":"Incidence Rates of Post-ERCP Complications: A Systematic Survey of Prospective Studies","volume":"102","author":"Andriulli","year":"2007","journal-title":"Am. 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