Current approaches and questions yet to be resolved for the prophylaxis of post-endoscopic retrograde cholangiopancreatography pancreatitis

Table 1 Risk factors for post-endoscopic retrograde cholangiopancreatography pancreatitis in the European Society of Gastrointestinal Endoscopy and American Society for Gastrointestinal Endoscopy guidelines

ESGE guideline	ASGE guideline
Patient-related definitive risk factors	Patient-related risk factors
Suspected sphincter of Oddi dysfunction	Suspected sphincter of Oddi dysfunction
Female sex	Female sex
Previous pancreatitis	Previous recurrent pancreatitis
Previous post-ERCP pancreatitis	Previous post-ERCP pancreatitis
Procedure-related definitive risk factors	Younger age
Difficult cannulation	Absence of chronic pancreatitis
More than one pancreatic guidewire passage	Normal serum bilirubin
Pancreatic injection	Procedure-related risk factors
Patient-related likely risk factors	Difficult cannulation (> 10 min)
Younger age	Repeated pancreatic guidewire cannulation
Nondilated extrahepatic bile duct	Pancreatic injection
Absence of chronic pancreatitis	Endoscopic papillary large-balloon dilation of a native papilla
Normal serum bilirubin
End-stage renal failure
Procedure-related likely risk factors
Precut sphincterotomy
Pancreatic sphincterotomy
Papillary balloon dilation
Unsuccessful clearance of bile duct stones
Intraductal ultrasound

ASGE: American Society for Gastrointestinal Endoscopy; ERCP: Endoscopic retrograde cholangiopancreatography; ESGE: European Society of Gastrointestinal Endoscopy.