Question:
Which of the following statements regarding post-ERCP pancreatitis (PEP) is accurate?
Which of the following statements regarding post-ERCP pancreatitis (PEP) is accurate?
Show Hint
High-Risk Factors for Post-ERCP Pancreatitis (PEP):
- Patient factors: Female gender, young age, suspected Sphincter of Oddi Dysfunction (SOD), previous history of PEP.
- Procedure factors: Difficult/prolonged cannulation, pancreatic duct contrast injection, precut sphincterotomy.
- Prevention: Rectal Indomethacin + aggressive IV hydration.
- Patient factors: Female gender, young age, suspected Sphincter of Oddi Dysfunction (SOD), previous history of PEP.
- Procedure factors: Difficult/prolonged cannulation, pancreatic duct contrast injection, precut sphincterotomy.
- Prevention: Rectal Indomethacin + aggressive IV hydration.
Updated On: Sep 3, 2026
- More common in females and older patients
- Occurs more frequently after diagnostic procedures than therapeutic ones
- Octreotide helps prevent post-ERCP pancreatitis
- In high-risk patients, incidence may reach up to 15%
Show Solution
Verified By Collegedunia
The Correct Option is D
Solution and Explanation
Concept:
Post-ERCP Pancreatitis (PEP) is the most common and feared complication of Endoscopic Retrograde Cholangiopancreatography, requiring an understanding of patient-specific and procedure-specific risk factors.
Explanation:
• Option A: PEP is more common in females, but it is paradoxically more common in younger patients, not older patients. Older age is actually somewhat protective.
• Option B: While therapeutic procedures involving the pancreatic duct (like sphincterotomy) carry risk, diagnostic ERCP—particularly for conditions like suspected Sphincter of Oddi Dysfunction (SOD) where the papilla is repeatedly manipulated or injected—carries an exceptionally high risk of PEP. However, as a blanket statement, complex therapeutic maneuvers generally increase risk overall.
• Option C: Pharmacological prophylaxis with Somatostatin or Octreotide has yielded conflicting results and is not routinely recommended by major guidelines. The proven, guideline-endorsed prophylaxis is the administration of rectal NSAIDs (Indomethacin or Diclofenac) immediately before or after the procedure.
• Option D: The overall incidence of PEP in unselected patients is around 3-5%. However, in defined high-risk cohorts (e.g., young females with Sphincter of Oddi Dysfunction, difficult cannulation, multiple pancreatic duct injections), the incidence rises dramatically and can easily reach 15% (and in some series, up to 30%). Thus, this statement is medically accurate.
Final Answer:
In highly susceptible demographic and procedural cohorts, the incidence of Post-ERCP Pancreatitis can indeed reach up to 15%.
Post-ERCP Pancreatitis (PEP) is the most common and feared complication of Endoscopic Retrograde Cholangiopancreatography, requiring an understanding of patient-specific and procedure-specific risk factors.
Explanation:
• Option A: PEP is more common in females, but it is paradoxically more common in younger patients, not older patients. Older age is actually somewhat protective.
• Option B: While therapeutic procedures involving the pancreatic duct (like sphincterotomy) carry risk, diagnostic ERCP—particularly for conditions like suspected Sphincter of Oddi Dysfunction (SOD) where the papilla is repeatedly manipulated or injected—carries an exceptionally high risk of PEP. However, as a blanket statement, complex therapeutic maneuvers generally increase risk overall.
• Option C: Pharmacological prophylaxis with Somatostatin or Octreotide has yielded conflicting results and is not routinely recommended by major guidelines. The proven, guideline-endorsed prophylaxis is the administration of rectal NSAIDs (Indomethacin or Diclofenac) immediately before or after the procedure.
• Option D: The overall incidence of PEP in unselected patients is around 3-5%. However, in defined high-risk cohorts (e.g., young females with Sphincter of Oddi Dysfunction, difficult cannulation, multiple pancreatic duct injections), the incidence rises dramatically and can easily reach 15% (and in some series, up to 30%). Thus, this statement is medically accurate.
Final Answer:
In highly susceptible demographic and procedural cohorts, the incidence of Post-ERCP Pancreatitis can indeed reach up to 15%.
Was this answer helpful?
0
0
Top NEET SS Surgical Questions
- A post-mastectomy patient (for malignant breast lump) who also had axillary lymph node dissection now presents in the postoperative period (after drain removal) with a soft, fluctuant swelling in the axilla extending into the mastectomy site.
- A patient presents with a large, multilobulated breast tumour clinically suggestive of phyllodes tumour, and there is a significant family history of breast cancer (grandmother) and prostate cancer (father). What is the next step in management?
- In a young woman with a breast lump confirmed on ultrasound to be a simple cyst, what is the next step in management?
- A 45-year-old woman underwent investigations for a breast lump. Her biopsy report confirms invasive ductal carcinoma of the breast. You are the surgical resident in charge and need to communicate the diagnosis to her. What is the most appropriate approach?
- A 35-year-old woman, a chronic smoker, presents with recurrent painful periareolar swelling and purulent nipple discharge for the past 6 months. She has undergone incision and drainage twice, but the symptoms recur after a short period. Which of the following statements about the most likely diagnosis is true?
View More Questions
Top NEET SS Hepatobiliary and Pancreatic Surgery Questions
- Hilar cholangiocarcinoma surgery is done for which of the following?
- Which of the following types of gallbladder polyps has a low malignant potential?
- A patient with gallbladder carcinoma has a tumor that involves the peritoneal side without serosa invasion. Four regional lymph nodes are positive for metastasis. According to the AJCC (TNM) staging system, what is the stage (T and N classification) of this tumor?
- Which is not a risk factor for cholangio carcinoma?
- In which of the following given neoplasms does CEA$>192\text{ng/ml}$ and serum amylase value is normal?
View More Questions
Top NEET SS Questions
- A liver transplant patient presents with diarrhoea, colitis, a total leukocyte count of 1800, and a positive blood CMV PCR. What is the next step in management?
- A 32-year-old male recovering from dengue fever initially showed clinical improvement but now presents with recurrence of high-grade fever, fatigue, and pancytopenia on day 10 of illness. He is hemodynamically stable with no bleeding manifestations. Which of the following investigations should be performed first to evaluate the cause of relapse and cytopenia?
- A 48-year-old man with chronic hepatitis C infection is being evaluated for risk factors associated with progression of liver disease. He has a 20-year history of infection, drinks alcohol occasionally, and has a high serum HCV RNA viral load. Which of the following factors is not associated with an increased risk of progression of liver disease in chronic HCV infection?
- A 28-year-old veterinary worker who previously received a full 3-dose pre-exposure rabies vaccination series is bitten by a stray dog while handling an animal in the clinic. The wound is cleaned immediately. What is the most appropriate post-exposure management?
- A 42-year-old patient undergoing chemotherapy for acute myeloid leukemia develops neutropenia (ANC $<$ 500) and is treated with broad-spectrum antibiotics. After initial recovery of neutrophil counts (ANC = 1500), he again develops high-grade fever and right upper quadrant abdominal pain. Imaging shows multiple small hypodense lesions in the liver and spleen. What is the most likely diagnosis?
View More Questions