A 50-year-old patient develops post-ERCP pancreatitis. The most significant independent risk factor for this complication is:

• A Dilated common bile duct on pre-procedure imaging
• B Sphincter of Oddi dysfunction (SOD) requiring sphincter manometry ✓
• C Male sex and age >70 years
• D Previous cholecystectomy

Explanation

Sphincter of Oddi dysfunction (SOD) is the strongest independent risk factor for post-ERCP pancreatitis, with rates up to 25–30% in this group (compared to 3–5% overall). SOD leads to repeated contrast injection attempts, difficult cannulation, and acinar cell injury. Rectal indomethacin and pancreatic duct stenting are evidence-based prophylactic strategies in high-risk patients. A dilated CBD actually lowers risk as it facilitates easier cannulation.

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.