Increased Use of Prophylactic Measures in Preventing Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis

Dutch Pancreatitis Study Group

Research output: Contribution to JournalArticleAcademicpeer-review

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Background: Nonsteroidal anti-inflammatory drugs (NSAIDs), pancreatic duct stenting, and intensive intravenous hydration have been proven to prevent post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis. Trial participation and guideline changes demanded an assessment of the clinical practice of post-ERCP pancreatitis prophylaxis. Aims: The surveys aim to identify points of improvement to inform and educate ERCPists about current evidence-based practice. Methods: Two anonymous surveys were conducted among Dutch gastroenterologists in 2013 (n = 408) and 2020 (n = 575) for longitudinal views and attitudes pertaining to post-ERCP pancreatitis prophylaxis and recognition of post-ERCP pancreatitis risk factors. Results: In 2013 and 2020, respectively, 121 and 109 ERCPists responded. In the 2013 survey, 98% of them utilized NSAID prophylaxis and 62% pancreatic duct stent prophylaxis in specific cases. In the 2020 survey, the use of NSAIDs (100%), pancreatic duct stents (78%), and intensive intravenous hydration (33%) increased among ERCPists. NSAID prophylaxis was the preferred prophylactic measure for all risk factors in the 2020 survey, except for ampullectomy, pancreatic duct contrast injection, and pancreatic duct cannulation, for which NSAID prophylaxis and pancreatic duct stent combined was equally favored or preferred. Conclusion: Rectal NSAIDs are the most applied post-ERCP pancreatitis prophylaxis in the Netherlands, followed by pancreatic duct stents and intensive intravenous hydration. Additionally, there is reason to believe that recent guideline updates and active research participation have led to increased prophylaxis implementation.
Original languageEnglish
Pages (from-to)4457-4466
Number of pages10
JournalDigestive diseases and sciences
Issue number12
Early online date2021
Publication statusPublished - Dec 2021


  • ERCP
  • Endoscopic retrograde cholangiopancreatography
  • Gastroenterologists
  • Infusions
  • Intravenous
  • Nonsteroidal anti-inflammatory agents
  • Pancreatic ducts
  • Pancreatitis
  • Risk factors
  • Risk reduction behavior
  • Surveys and questionnaires

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