End of the Road for Epinephrine Spraying of the Papilla to Prevent Post–Endoscopic Retrograde Cholangiopancreatography Pancreatitis?

Abstract

Endoscopic retrograde cholangiopancreatography (ERCP) remains the endoscopic intervention that is routinely performed by gastroenterologists that carries the highest risk of serious adverse events, the most frequent of which is post-ERCP pancreatitis (PEP). Substantial efforts have been undertaken to further the science of patient selection and prophylactic measures to reduce the risk of PEP. Yet, the rate of PEP pancreatitis remains 3%–15%, dependent on patient, procedure, and provider risk factors.