Which of the following is the MOST common post-ERCP complication, and what is the primary predictor of its severity?
- A Cholangitis; severity predicted by biliary obstruction duration
- B Pancreatitis; severity predicted by serum amylase at 2 hours post-procedure ✓
- C Bleeding; severity predicted by platelet count
- D Perforation; severity predicted by sphincterotomy length
Correct answer: B. Pancreatitis; severity predicted by serum amylase at 2 hours post-procedure
Explanation
Post-ERCP pancreatitis (PEP) is the most common complication of ERCP, occurring in 3-5% of unselected patients and up to 15% of high-risk cases. Serum amylase elevation at 2-4 hours post-ERCP is a key early predictor — a value <1.5 times upper limit of normal effectively excludes PEP. Risk factors include female sex, sphincter of Oddi dysfunction, prior PEP, and difficult cannulation. Rectal NSAIDs (indomethacin/diclofenac) are given prophylactically.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.