Local Postprocedural Cryoprevention Significantly Reduces the Incidence of Post-ERCP Pancreatitis: A Multicenter...

Area of Science:

• Gastroenterology
• Endoscopic Procedures
• Clinical Trials

Background:

• Post-ERCP pancreatitis (PEP) is a frequent complication of ERCP.
• Rectal NSAIDs are recommended for PEP prevention but have limited use in Japan.
• Novel strategies are needed to mitigate PEP risk.

Purpose of the Study:

• To evaluate the efficacy and safety of ice water irrigation (cryoprevention) for reducing PEP incidence.
• To compare cryoprevention with standard care in a multicenter randomized controlled trial.

Main Methods:

• 880 adult patients undergoing ERCP with a native papilla were enrolled.
• Patients were randomized to either cryoprevention (ice water irrigation) or a control group.
• PEP incidence was the primary outcome, defined by specific clinical and laboratory criteria.

Main Results:

• PEP incidence was significantly lower in the cryoprevention group (3.2%) compared to the control group (6.8%) (P=0.02).
• Cryoprevention achieved a 52.4% relative risk reduction in PEP.
• No significant differences were found in secondary outcomes like cholangitis, bleeding, or perforation.

Conclusions:

• Cryoprevention using ice water is a safe, effective, and low-cost strategy for reducing PEP.
• This method provides a practical alternative for PEP prevention, especially where NSAID use is restricted.