Effects of medications on post-endoscopic retrograde cholangiopancreatography pancreatitis

Pancreatology. 2010;10(2-3):238-42. doi: 10.1159/000279306. Epub 2010 May 13.


Background and aims: Drug-induced pancreatitis accounts for about 2% of acute pancreatitis. The aim of this study is to determine whether propofol and other medications are associated with increased risk for post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis.

Methods: A retrospective study was conducted at a single tertiary care hospital. All patients who underwent ERCP from 2001 to 2004 were included. Diagnosis of acute post-ERCP pancreatitis was based on a consensus definition.

Results: A total of 506 patients underwent ERCP. The total incidence of post-ERCP pancreatitis was 7.1%. There was no significant difference in post-ERCP pancreatitis between patients who received propofol compared to patients who received midazolam and fentanyl (9.0 vs. 5.9%, p = 0.18). Patients receiving an angiotensin receptor blocker were approximately 4 times more likely to develop post-ERCP pancreatitis (OR = 4.1, 95% CI 1.6-10.9). Patients younger than 65 years and smokers also had higher risk of developing acute post-ERCP pancreatitis than those who were older than 65 years (OR = 3.9, 95% CI 1.7-9.1) and non-smokers (OR = 2.8, 95% CI 1.3-6.2).

Conclusions: Propofol is a safe sedative drug for ERCP without additional risk of developing acute post-ERCP pancreatitis. Use of angiotensin receptor blockers, smoking and younger age are independent risk factors for post-ERCP pancreatitis.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Angiotensin Receptor Antagonists
  • Cholangiopancreatography, Endoscopic Retrograde / adverse effects*
  • Female
  • Fentanyl / adverse effects*
  • Humans
  • Hypnotics and Sedatives / adverse effects*
  • Male
  • Midazolam / adverse effects*
  • Middle Aged
  • Pancreatitis / chemically induced*
  • Propofol / adverse effects*
  • Retrospective Studies
  • Risk Factors
  • Smoking / adverse effects


  • Angiotensin Receptor Antagonists
  • Hypnotics and Sedatives
  • Midazolam
  • Fentanyl
  • Propofol