Post-ERCP pancreatitis(PEP) is the most common complication following endoscopic retrograde cholangiopancreatography (ERCP) and represents a frequent clinical challenge. Placement of an endoscopic retrograde pancreatic duct drainage (ERPD) stent has been recognized as an important preventive measure against post-ERCP pancreatitis. The aim of this study was to identify factors associated with post-ERCP pancreatitis in patients who underwent ERPD placement

This single - tertiary center retrospective study was conducted at Chosun University Hospital and included patients who underwent ERCP between January 1, 2024, and December 31, 2024. A total of 576 ERCP procedures were performed during the study period, of which 60 cases involved the placement of an ERPD. Among patients who received an ERPD, potential risk factors associated with post-ERCP pancreatitis (PEP) were evaluated, including age, sex, naïve cannulation, cannulation time, procedure time, endoscopic papillary balloon dilation (EPBD), and trainee involvement.

Among the 60 patients who received an ERPD, the incidence of post-ERCP pancreatitis (PEP) was 21 cases (35%), which was higher compared with the overall ERCP population. The mean cannulation time was longer in patients who developed PEP compared with those who did not (637 seconds vs. 516.6 seconds), although the difference did not reach statistical significance (P=0.343). Similarly, the mean procedure time tended to be longer in the PEP group (34.1 minutes vs. 30.69 minutes), but this difference was also not statistically significant (P=0.242). No risk factors evaluated in this study demonstrated a statistically significant association with the development of PEP.

Among patients who received an ERPD, no procedure-related factors were identified as predictors of increased risk for PEP. These findings suggest that ERPD placement itself may be the most important procedural measure for preventing PEP.