Prevention of post-ERCP complications

Endoscopic retrograde cholangiopancreatography (ERCP) is a common endoscopic procedure which plays a key
role in the management of diseases of the bile ducts and the pancreas. Despite ERCP being performed routinely
since more than 4 decades, it is still related to a considerable rate of complications with post-ERCP pancreatitis
being the most frequent one.
Lately, endoscopic techniques have evolved, and numerous modalities have been developed to prevent or
manage ERCP-related complications, especially PEP, such as the use of intra-rectal non-steroidal anti-
inflammatory drugs (NSAIDs), insertion of prophylactic stents in the pancreatic duct (PD) or intravenous
hyperhydration. Knowledge of the various risk factors and applying validated preventive methods are keys in
providing a safe procedure and optimizing overall patient care.