Endoscopic retrograde cholangiopancreatography (ERCP) remains a key procedure in the therapeutic management of biliary and pancreatic diseases, particularly lithiasis. Its complications are mainly dominated by acute pancreatitis.The aim of our study is to assess the frequency and predictive factors of ERCP-related complications.

We retrospectively included all patients who underwent ERCP between September 2024 and September 2025 for lithiasic disease.Statistical analysis was performed using the Jamovi software. The associated factors studied were: age, sex, history of ERCP, use of NSAIDs before the procedure, cannulation of the pancreatic duct and the number of passages into the Wirsung duct, performance of a precut, and the total duration of the procedure.

A total of 31 patients were included. The mean age was 58.4 ± 15.3 years, with a sex ratio of 0.47. Four patients (12.9%) had a history of ERCP. Twenty-four patients (80%) received NSAIDs prior to the procedure. Sphincterotomy was performed in 30 patients (96.8%), and a precut was required in 2 patients (6.7%). Accidental cannulation of the Wirsung duct occurred in 13 patients. The stone extraction success rate was 80.6%.

Regarding complications, 3 patients developed acute pancreatitis, and 1 patient experienced bleeding, which was controlled by pneumatic compression of the margins.

In univariate analysis, factors associated with the occurrence of complications were: the number of passages into the Wirsung duct, procedure duration, and NSAID use before the procedure.In multivariate analysis, only the number of passages into the Wirsung duct appeared to be associated with the occurrence of complications (p = 0.04; OR = 1.7; 95% CI [0.9–2.3]).

Only the number of passages into the Wirsung duct appears to be a predictive factor for the occurrence of complications.