• 1
    Freeman ML, DiSario JA, Nelson DB, et al. Risk factors for post-ERCP pancreatitis: a prospective, multicenter study. Gastrointest Endosc 2001; 54: 42534.
  • 2
    Cheng CL, Sherman S, Watkins JL, et al. Risk factors for post-ERCP pancreatitis: a prospective multicenter study. Am J Gastroenterol 2006; 101: 13947.
    Direct Link:
  • 3
    Wang P, Li ZS, Liu F, et al. Risk factors for ERCP-related complications: a prospective multicenter study. Am J Gastroenterol 2009; 104: 3140.
  • 4
    Zhou W, Li Y, Zhang Q, et al. Risk factors for postendoscopic retrograde cholangiopancreatography pancreatitis: a retrospective analysis of 7,168 cases. Pancreatology 2011; 11: 399405.
  • 5
    Brust R, Thomson AB, Wensel RH, et al. Pancreatic injury following ERCP. Failure of prophylactic benefit of Trasylol. Gastrointest Endosc 1977; 24: 779.
  • 6
    Odes HS, Novis BN, Barbezat GO, et al. Effect of calcitonin on the serum amylase levels after endoscopic retrograde cholangiopancreatography. Digestion 1977; 16: 1804.
  • 7
    Arata S, Takada T, Hirata K, et al. Post-ERCP pancreatitis. J Hepatobiliary Pancreat Sci 2010; 17: 708.
  • 8
    Anderson MA, Fisher L, Jain R, et al. Complications of ERCP. Gastrointest Endosc 2012; 75: 46773.
  • 9
    Dumonceau JM, Andriulli A, Deviere J, et al. European Society of Gastrointestinal Endoscopy (ESGE) Guideline: prophylaxis of post-ERCP pancreatitis. Endoscopy 2010; 42: 50315.
  • 10
    Elmunzer BJ, Scheiman JM, Lehman GA, et al. A randomized trial of rectal indomethacin to prevent post-ERCP pancreatitis. N Engl J Med 2012; 366: 14142211.
  • 11
    Ades AE. ISPOR states its position on network meta-analysis. Value Health 2011; 14: 4146.
  • 12
    Li T, Puhan MA, Vedula SS, et al. Network meta-analysis-highly attractive but more methodological research is needed. BMC Med 2011; 9: 79.
  • 13
    Lefebvre C, Manheimer E, Glanville J. Chapter 6: searching for studies. In: Higgins JPT, Green S, eds. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available at: Accessed January 18, 2012.
  • 14
    Elmunzer BJ, Waljee AK, Elta GH, et al. A meta-analysis of rectal NSAIDs in the prevention of post-ERCP pancreatitis. Gut 2008; 57: 12627.
  • 15
    Dai HF, Wang XW, Zhao K. Role of nonsteroidal anti-inflammatory drugs in the prevention of post-ERCP pancreatitis: a meta-analysis. Hepatobiliary Pancreat Dis Int 2009; 8: 116.
  • 16
    Zheng MH, Xia HH, Chen YP. Rectal administration of NSAIDs in the prevention of post-ERCP pancreatitis: a complementary meta-analysis. Gut 2008; 57: 16323.
  • 17
    Omata F, Deshpande G, Tokuda Y, et al. Meta-analysis: somatostatin or its long-acting analogue, octreotide, for prophylaxis against post-ERCP pancreatitis. J Gastroenterol 2010; 45: 88595.
  • 18
    Andriulli A, Caruso N, Quitadamo M, et al. Antisecretory vs. antiproteasic drugs in the prevention of post-ERCP pancreatitis: the evidence-based medicine derived from a meta-analysis study. JOP 2003; 4: 418.
  • 19
    Chen B, Fan T, Wang CH. A meta-analysis for the effect of prophylactic GTN on the incidence of post-ERCP pancreatitis and on the successful rate of cannulation of bile ducts. BMC Gastroenterol 2010; 10: 85.
  • 20
    Shao LM, Chen QY, Chen MY, et al. Nitroglycerin in the prevention of post-ERCP pancreatitis: a meta-analysis. Dig Dis Sci 2010; 55: 17.
  • 21
    Bang UC, Nojgaard C, Andersen PK, et al. Meta-analysis: nitroglycerin for prevention of post-ERCP pancreatitis. Aliment Pharmacol Ther 2009; 29: 107885.
  • 22
    Bai Y, Xu C, Yang X, et al. Glyceryl trinitrate for prevention of pancreatitis after endoscopic retrograde cholangiopancreatography: a meta-analysis of randomized, double-blind, placebo-controlled trials. Endoscopy 2009; 41: 6905.
  • 23
    Li S, Cao G, Chen X, et al. Low-dose heparin in the prevention of post endoscopic retrograde cholangiopancreatography pancreatitis: a systematic review and meta-analysis. Eur J Gastroenterol Hepatol 2012; 24: 47781.
  • 24
    Chen S, Shi H, Zou X, et al. Role of ulinastatin in preventing post-endoscopic retrograde cholangiopancreatography pancreatitis: the Emperor's New Clothes or Aladdin's Magic Lamp? Pancreas 2010; 39: 12317.
  • 25
    Zheng M, Chen Y, Bai J, et al. Meta-analysis of prophylactic allopurinol use in post-endoscopic retrograde cholangiopancreatography pancreatitis. Pancreas 2008; 37: 24753.
  • 26
    Bai Y, Gao J, Zhang W, et al. Meta-analysis: allopurinol in the prevention of postendoscopic retrograde cholangiopancreatography pancreatitis. Aliment Pharmacol Ther 2008; 28: 55764.
  • 27
    Zheng M, Bai J, Yuan B, et al. Meta-analysis of prophylactic corticosteroid use in post-ERCP pancreatitis. BMC Gastroenterol 2008; 8: 6.
  • 28
    Bai Y, Gao J, Shi X, et al. Prophylactic corticosteroids do not prevent post-ERCP pancreatitis: a meta-analysis of randomized controlled trials. Pancreatology 2008; 8: 5049.
  • 29
    Ding X, Chen M, Huang S, et al. Nonsteroidal anti-inflammatory drugs for prevention of post-ERCP pancreatitis: a meta-analysis. Gastrointest Endosc 2012; 76: 11529.
  • 30
    Gu WJ, Wei CY, Yin RX. Antioxidant supplementation for the prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis: a meta-analysis of randomized controlled trials. Nutr J 2013; 12: 23.
  • 31
    Yuhara H, Ogawa M, Kawaguchi Y, et al. Pharmacologic prophylaxis of post-endoscopic retrograde cholangiopancreatography pancreatitis: protease inhibitors and NSAIDs in a meta-analysis. J Gastroenterol 2013 [Epub ahead of print].
  • 32
    Higgins JPT, Green S(eds). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available at: Accessed January 18, 2012.
  • 33
    Agency for Healthcare Research and Quality. Methods Reference Guide for Effectiveness and Comparative Effectiveness Reviews, Version 1.0 (Draft posted October 2007). Rockville, MD. Available at: Accessed January 18, 2012.
  • 34
    Higgins JPT, Altman DG, Sterne JAC, eds. Chapter 8: Assessing risk of bias in included studies. In: Higgins JPT, Green S, (eds). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0(updated March 2011). The Cochrane Collaboration 2011. Available at: Accessed January 18, 2012.
  • 35
    Ades AE, Welton N, Lu G. Mixed treatments comparisons. Available at: Accessed January 20, 2012.
  • 36
    Ntzoufras I. Bayesian Modeling Using WinBUGS. Hoboken, NJ: John Wiley & Sons, 2009.
  • 37
    Salanti G, Ades AE, Ioannidis JP. Graphical methods and numerical summaries for presenting results from multiple-treatment meta-analysis: an overview and tutorial. J Clin Epidemiol 2011; 64: 16371.
  • 38
    Jaynes ET. Confidence Intervals vs Bayesian Intervals. In: Hooker Harper WL, Hooker CA, ed. Foundations of Probability Theory, Statistical Inference, and Statistical Theories of Science. Dordrecht: D. Reidel, 1976: 175257.
  • 39
    White IR, Barrett JK, Jackson D, et al. Consistency and inconsistency in network meta-analysis: model estimation using multivariate meta-regression. Res Synthesis Methods 2012; 3: 11125.
  • 40
    Chatellier G, Zapletal E, Lemaitre D, et al. The number needed to treat: a clinically useful nomogram in its proper context. BMJ 1996; 312: 4269.
  • 41
    Andriulli A, Clemente R, Solmi L, et al. Gabexate or somatostatin administration before ERCP in patients at high risk for post-ERCP pancreatitis: a multicenter, placebo-controlled, randomized clinical trial. Gastrointest Endosc 2002; 56: 48895.
  • 42
    Andriulli A, Solmi L, Loperfido S, et al. Prophylaxis of ERCP-related pancreatitis: a randomized, controlled trial of somatostatin and gabexate mesylate. Clin Gastroenterol Hepatol 2004; 2: 7138.
  • 43
    Budzynska A, Marek T, Nowak A, et al. A prospective, randomized, placebo-controlled trial of prednisone and allopurinol in the prevention of ERCP-induced pancreatitis. Endoscopy 2001; 33: 76672.
  • 44
    Chen XT, Fei ZY, Shen YF, et al. Clinical observation on ulinastatin for the prevention of post-ERCP pancreatitis. Shandong Med J 2005; 45: 445.
  • 45
    Gong P, Wang ZY, Tai PJ, et al. Prevention and treatment for post ERCP pancreatitis. J Hepatobiliary Surg 2004; 12: 1013.
  • 46
    Kwon YH, Kim JY, Lee SJ, et al. Could nafamostat or gabexate prevent the post endoscopic retrograde cholangiopancreatography pancreatitis?. Korean J Gastroenterol 2012; 59: 2328.
  • 47
    Manolakopoulos S, Avgerinos A, Vlachogiannakos J, et al. Octreotide versus hydrocortisone versus placebo in the prevention of post-ERCP pancreatitis: a multicenter randomized controlled trial. Gastrointest Endosc 2002; 55: 4705.
  • 48
    Chen W, Chang Y, Yang J, et al. Clinical study of prophylactic effect of proton pump inhibitor combined with somatostatin and gabexate on post-ERCP pancreatitis and hyperamylasemia. Chin J Gastroenterol 2009; 14: 4147.
  • 49
    Gorgul A, Kayhan B, Mentes BB, et al. The comparison of the effect of somatostatin and SMS 201-995 on enzyme change following endoscopic retrograde cholangiopancreotography. Gazi Med J 1998; 9: 41165.
  • 50
    Arvanitidis D, Anagnostopoulos GK, Giannopoulos D, et al. Can somatostatin prevent post-ERCP pancreatitis? Results of a randomized controlled trial. J Gastroenterol Hepatol 2004; 19: 27882.
  • 51
    Chan HH, Lai KH, Lin CK, et al. Effect of somatostatin in the prevention of pancreatic complications after endoscopic retrograde cholangiopancreatography. J Chin Med Assoc 2008; 71: 6059.
  • 52
    Deviere J, Le Moine O, Van Laethem JL, et al. Interleukin 10 reduces the incidence of pancreatitis after therapeutic endoscopic retrograde cholangiopancreatography. Gastroenterology 2001; 120: 498505.
  • 53
    Fujishiro H, Adachi K, Imaoka T, et al. Ulinastatin shows preventive effect on post-endoscopic retrograde cholangiopancreatography pancreatitis in a multicenter prospective randomized study. J Gastroenterol Hepatol 2006; 21: 10659.
  • 54
    Manes G, Ardizzone S, Lombardi G, et al. Efficacy of postprocedure administration of gabexate mesylate in the prevention of post-ERCP pancreatitis: a randomized, controlled, multicenter study. Gastrointest Endosc 2007; 65: 9827.
  • 55
    Park KT, Kang DH, Choi CW, et al. Is high-dose nafamostat mesilate effective for the prevention of post-ERCP pancreatitis, especially in high-risk patients? Pancreas 2011; 40: 12159.
  • 56
    Sherman S, Cheng CL, Costamagna G, et al. Efficacy of recombinant human interleukin-10 in prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis in subjects with increased risk. Pancreas 2009; 38: 26774.
  • 57
    Song AL, Yin LN, Kou ZM. Preventive effects of ulinastatin on post ERCP hyperamylasemia and acute pancreatitis. J Lanzhou Univ (Med Sci) 2005; 31: 245.
  • 58
    Russo A, Virgilio C, Aprile G, et al. Effect of octreotide on pancreatic reactions following ERCP. Giornale Italiano di Endoscopia Digestiva 1992; 15: 13945.
  • 59
    Baldazzi G, Conti C, Spotti EG, et al. Prevention of post-ERCP acute pancreatitis with octreotide. Il Giornale di chirurgia 1994; 15: 35962.
  • 60
    Montano Loza A, Garcia Correa J, Gonzalez Ojeda A, et al. Prevention of hyperamilasemia and pancreatitis after endoscopic retrograde cholangiopancreatography with rectal administration of indomethacin. Rev Gastroenterol Mex 2006; 71: 2628.
  • 61
    Montano Loza A, Rodriguez Lomeli X, Garcia Correa JE, et al. Effect of the administration of rectal indomethacin on amylase serum levels after endoscopic retrograde cholangiopancreatography, and its impact on the development of secondary pancreatitis episodes. Revista espanola de enfermedades digestivas: organo oficial de la Sociedad Espanola de Patologia Digestiva 2007; 99: 3306.
  • 62
    Wollschlager S, Patzold K, Bulang T, et al. Effect of preventive selenium administration on development of ERCP-induced acute pancreatitis. Med Klin (Munich) 1999; 94(Suppl. 3): 813.
  • 63
    Borsch G, Bergbauer M, Nebel W, et al. Effect of somatostatin on amylase level and pancreatitis rate following ERCP. Die Medizinische Welt 1984; 35: 10912.
  • 64
    Dobronte Z, Toldy E, Mark L, et al. Effects of rectal indomethacin in the prevention of post-ERCP acute pancreatitis. Orv Hetil 2012; 153: 9906.
  • 65
    Yasuda Y. Clinical effect of tripsin inhibitor (Urinastatin) for escape of pancreatic enzyme post ERCP. Jpn Pharmacol Ther 1987; 42: 7782.
  • 66
    Cotton PB, Lehman G, Vennes J, et al. Endoscopic sphincterotomy complications and their management: an attempt at consensus. Gastrointest Endosc 1991; 37: 38393.
  • 67
    Testoni PA, Bagnolo F, Andriulli A, et al. Octreotide 24-h prophylaxis in patients at high risk for post-ERCP pancreatitis: results of a multicenter, randomized, controlled trial. Aliment Pharmacol Ther 2001; 15: 96572.
  • 68
    Guelrud M, Mendoza S, Viera L, Gelrud D. Somatostatin prevents acute pancreatitis after pancreatic duct sphincter hydrostatic balloon dilation in patients with idiopathic recurrent pancreatitis. Gastrointest Endosc 1990; 36: 447.
  • 69
    Yoo JW, Ryu JK, Lee SH, et al. Preventive effects of ulinastatin on post-endoscopic retrograde cholangiopancreatography pancreatitis in high-risk patients: a prospective, randomized, placebo-controlled trial. Pancreas 2008; 37: 36670.
  • 70
    Mori S, Itoh Y, Shinohata R, et al. Nafamostat mesilate is an extremely potent inhibitor of human tryptase. J Pharmacol Sci 2003; 92: 4203.
  • 71
    Keck T. Site-specific therapeutic effects of protease inhibitors: effect of route of administration in experimental pancreatitis. Pancreatology 2001; 1: 65661.
  • 72
    Binmoeller KF, Dumas R, Harris AG, et al. Effect of somatostatin analog octreotide on human sphincter of Oddi. Dig Dis Sci 1992; 37: 7737.
  • 73
    Wu SD, Zhang ZH, Jin JZ, et al. Effects of different drugs on the sphincter of Oddi motility: study with choledochoscope manometry. Zhonghua yi xue za zhi 2005; 85: 19115.
  • 74
    Di Francesco V, Angelini G, Zoico E, et al. Effect of native somatostatin on sphincter of Oddi motility in patients with acute recurrent pancreatitis. A pilot study with ultrasound-secretin test. Dig Liver Dis 2006; 38: 26871.
  • 75
    Xu LH, Qian JB, Gu LG, et al. Prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis by epinephrine sprayed on the papilla. J Gastroenterol Hepatol 2011; 26: 113944.
  • 76
    Matsushita M, Takakuwa H, Shimeno N, et al. Epinephrine sprayed on the papilla for prevention of post-ERCP pancreatitis. J Gastroenterol 2009; 44: 715.
  • 77
    Pezzilli R, Romboli E, Campana D, et al. Mechanisms involved in the onset of post-ERCP pancreatitis. JOP 2002; 3: 1628.
  • 78
    Akashi R, Kiyozumi T, Tanaka T, et al. Mechanism of pancreatitis caused by ERCP. Gastrointest Endosc 2002; 55: 504.
  • 79
    Freeman ML, Guda NM. Prevention of post-ERCP pancreatitis: a comprehensive review. Gastrointest Endosc 2004; 59: 84564.
  • 80
    Elta GH, Barnett JL, Wille RT, et al. Pure cut electrocautery current for sphincterotomy causes less post-procedure pancreatitis than blended current. Gastrointest Endosc 1998; 47: 14953.
  • 81
    Stefanidis G, Karamanolis G, Viazis N, et al. A comparative study of postendoscopic sphincterotomy complications with various types of electrosurgical current in patients with choledocholithiasis. Gastrointest Endosc 2003; 57: 1927.
  • 82
    Verma D, Kapadia A, Adler DG. Pure versus mixed electrosurgical current for endoscopic biliary sphincterotomy: a meta-analysis of adverse outcomes. Gastrointest Endosc 2007; 66: 28390.
  • 83
    Buscaglia JM, Simons BW, Prosser BJ, et al. Severity of post-ERCP pancreatitis directly proportional to the invasiveness of endoscopic intervention: a pilot study in a canine model. Endoscopy 2008; 40: 50612.
  • 84
    Ohno T, Katori M, Nishiyama K, et al. Direct observation of microcirculation of the basal region of rat gastric mucosa. J Gastroenterol 1995; 30: 55764.
  • 85
    Igawa M, Miyaoka M, Saitoh T. Influence of topical epinephrine application on microcirculatory disturbance in subjects with ulcerative colitis evaluated by laser doppler flowmetry and transmission electron microscopy. Dig Endosc 2000; 12: 12630.
  • 86
    Nakahata N, Nakanishi H, Suzuki T. Depressive effect of epinephrine mediated via adrenergic beta-receptor in isolated rat colon and duodenum. Jpn J Pharmacol 1977; 27: 3419.
  • 87
    Sarles JC, Awad R. Role of the autonomic nervous system in the rabbit sphincter of Oddi. Surg Gastroenterol 1984; 3: 416.
  • 88
    Alvan G, Orme M, Bertilsson L, et al. Pharmacokinetics of indomethacin. Clin Pharmacol Ther 1975; 18: 36473.
  • 89
    Helleberg L. Clinical pharmacokinetics of indomethacin. Clinical Pharmacokinet 1981; 6: 24558.
  • 90
    Mazaki T, Mado K, Masuda H, et al. Prophylactic pancreatic stent placement and post-ERCP pancreatitis: an updated meta-analysis. J Gastroenterol 2013; PMID: 23612857 [Epub ahead of print].
  • 91
    Harewood GC, Pochron NL, Gostout CJ. Prospective, randomized, controlled trial of prophylactic pancreatic stent placement for endoscopic snare excision of the duodenal ampulla. Gastrointest Endosc 2005; 62: 36770.
  • 92
    Kawaguchi Y, Ogawa M, Omata F, et al. Randomized controlled trial of pancreatic stenting to prevent pancreatitis after endoscopic retrograde cholangiopancreatography. World J Gastroenterol 2012; 18: 163541.
  • 93
    Spellberg B, Bartlett JG, Gilbert DN. The future of antibiotics and resistance. N Engl J Med 2013; 368: 299302.
  • 94
    Medicare Part B Drug Average Sales Price. Volume 2012. Centers for Medicare & Medicaid Services. Available at: Accessed September 15, 2012.
  • 95
    Das A, Singh P, Sivak MV Jr, et al. Pancreatic-stent placement for prevention of post-ERCP pancreatitis: a cost-effectiveness analysis. Gastrointest Endosc 2007; 65: 9608.
  • 96
    Elmunzer BJ, Higgins PD, Saini SD, et al. Does rectal indomethacin eliminate the need for prophylactic pancreatic stent placement in patients undergoing high-risk ERCP? Post hoc efficacy and cost-benefit analyses using prospective clinical trial data. Am J Gastroenterol 2013; 108: 4105.