Incidence and Risk Factors of Post-endoscopic Retrograde Cholangiopancreatography (ERCP) Acute Pancreatitis in a Mexican Secondary-Level Hospital: A Retrospective Study

The observed incidence of PEP was consistent with that reported in international series. Cannulation attempts exceeding three were statistically associated with an increased risk of PEP. The apparent association of rectal indomethacin with PEP likely reflects confounding by indication, as its use was concentrated in high-risk patients. These findings highlight the need for multicentre studies to confirm these associations and reinforce the implementation of standardised prophylactic strategies, even in secondary-level hospitals.