{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T22:28:08Z","timestamp":1790116088161,"version":"4.0.1"},"reference-count":23,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T00:00:00Z","timestamp":1759104000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.mdpi.com"],"crossmark-restriction":true},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP) remains the most frequent and clinically significant complication of ERCP, with a multifactorial etiology involving patient- and procedure-related risk factors. Despite preventive measures such as NSAIDs and peri-procedural stenting, the incidence of PEP has not substantially declined. We aimed to assess clinical determinants of PEP in a large real-world cohort treated with standardized procedural protocols. Materials and Methods: This retrospective single-center study analyzed 806 patients who underwent ERCP between January 2019 and December 2021. All procedures were performed by a single operator under general anesthesia with standardized prophylaxis (diclofenac 100 mg per rectum and cefazolin 2 g intravenously). Patients with delayed ERCP (&gt;48 h from admission) or active acute pancreatitis were excluded. Logistic regression was used to identify independent predictors of PEP, hospital stay, and in-hospital mortality. Results: PEP occurred in 60 patients (7.4%). Independent risk factors included stenosis of the papilla of Vater (OR = 2.45; p = 0.025), gallbladder stones (OR = 2.66; p = 0.001), prior acute pancreatitis (OR = 2.72; p = 0.005), and sphincterotomy (OR = 2.53; p = 0.016). PEP was associated with longer hospitalization (MD = 4.5 days; p &lt; 0.001) and increased in-hospital mortality (6.7% vs. 1.7%; p = 0.032). Conclusion: Stenosis of the papilla, gallbladder stones, prior acute pancreatitis, and sphincterotomy independently increased the risk of PEP, whereas older age, previous ERCP, and pancreaticoduodenal tumors were associated with a reduced risk. Despite standardized prophylaxis, PEP remains a relevant clinical concern. Identification of high-risk patients and individualized procedural planning are essential to minimizing complications.<\/jats:p>","DOI":"10.3390\/jcm14196916","type":"journal-article","created":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T09:12:23Z","timestamp":1759223543000},"page":"6916","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["More Than Just a Complication: Post-ERCP Pancreatitis and Its Clinical Determinants in over 800 Procedures"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9653-9841","authenticated-orcid":false,"given":"\u0141ukasz","family":"Nawacki","sequence":"first","affiliation":[{"name":"Collegium Medicum, Jan Kochanowski University, Aleja IX Wiek\u00f3w Kielc 19, 25-369 Kielce, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agnieszka","family":"Bociek","sequence":"additional","affiliation":[{"name":"Collegium Medicum, Jan Kochanowski University, Aleja IX Wiek\u00f3w Kielc 19, 25-369 Kielce, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ada","family":"Bielejewska","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care, Center of Postgraduate Medical Education, Orlowski Hospital, 00-416 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7619-8426","authenticated-orcid":false,"given":"Iwona","family":"Gorczyca-G\u0142owacka","sequence":"additional","affiliation":[{"name":"Collegium Medicum, Jan Kochanowski University, Aleja IX Wiek\u00f3w Kielc 19, 25-369 Kielce, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7752-0459","authenticated-orcid":false,"given":"Stanis\u0142aw","family":"G\u0142uszek","sequence":"additional","affiliation":[{"name":"Holy Cross Cancer Hospital, Artwi\u0144skiego 3, 25-734 Kielce, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.pan.2017.01.005","article-title":"The incidence and aetiology of acute pancreatitis across Europe","volume":"17","author":"Roberts","year":"2017","journal-title":"Pancreatology"},{"key":"ref_2","first-page":"1","article-title":"Epidemiology of acute pancreatitis in Poland\u2014Selected problems","volume":"32","year":"2016","journal-title":"Med. 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