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Can pancreatitis occur after ERCP?

Nov 03, 2025 Source: Cainiu Health
Dr. Gao Jun
Introduction
Underlying conditions such as gallstones, bile duct strictures, or pancreatic anatomical abnormalities, as well as repeated opacification of the pancreatic duct and instrument irritation of the pancreatic duct orifice during procedures, increase the risk of developing pancreatitis. In some patients, postoperative obstruction of pancreatic juice drainage leads to abnormal activation of pancreatic enzymes, triggering pancreatic inflammation and resulting in symptoms such as abdominal pain and fever.

Generally, pancreatitis may occur after ERCP. The risk increases when high-risk factors are present, while it remains low in the absence of such factors and when the procedure is performed properly. If there are concerns, it is recommended to consult a healthcare provider in advance. A detailed analysis is as follows:

Underlying conditions such as gallstones, bile duct strictures, or pancreatic anatomical abnormalities, as well as repeated opacification of the pancreatic duct during the procedure or instrument irritation of the pancreatic duct opening, can increase the risk of developing pancreatitis. In some patients, postoperative obstruction of pancreatic juice drainage leads to abnormal activation of pancreatic enzymes, triggering pancreatic inflammation and resulting in symptoms such as abdominal pain and fever.

If the patient has no underlying pancreatic or biliary diseases, the procedure is performed by an experienced operator following standardized protocols, and preventive measures are promptly implemented postoperatively, the likelihood of developing pancreatitis is significantly reduced. In such cases, the pancreatic duct is not excessively irritated, secretion and drainage of pancreatic juice remain normal, and the body can recover smoothly without experiencing pancreatitis-related discomfort.

After ERCP, close monitoring of abdominal symptoms and body temperature is essential. Patients should immediately inform their doctor if persistent abdominal pain, nausea, or similar symptoms occur. Postoperative fasting and fluid replacement should be strictly followed as prescribed to avoid premature eating, which could stimulate excessive pancreatic secretion. Patients with pre-existing conditions should undergo thorough preoperative evaluation to minimize the risk of postoperative complications.

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