New study explores preventive scope procedure for pancreatitis patients too frail for surgery

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: 1. adult patients (above 18 years) 2. naïve papilla 3. evidence of AP based on the Atlanta criteria: * pain in the upper abdomen * serum amylase or lipase concentration \> 3 times the upper limit of normal * imaging features of acute pancreatitis on abdominal imaging 4. high probability of a biliary etiology: * gallstones or biliary sludge on imaging (any type) * dilated common bile duct on imaging defined as \> 8 mm in patients ≤ 75 years or \> 10 mm in patients \> 75 years * abnormal liver enzymes (alanine aminotransferase \[ALT\] two times the upper limit of normal) 5. patients unfit for surgery due to the attending physician's decision e.g. American Society of Anesthesiologists (ASA) class ≥ III; severe heart failure with reduced ejection fraction \<40%, severe uncontrolled hypertension, chronic kidney disease stage four or five Exclusion Criteria: 1. previous cholecystectomy 2. previous endoscopic sphincterotomy or pancreatobiliary stenting 3. ERCP/ES is recommended by the guidelines (3) * sign of cholangitis * presence of CBD stone on any imaging * signs of stone in endoscopic ultrasonography or magnetic resonance imaging in case of abnormal liver enzymes (persistently elevated ALT and aspartate aminotransferase (AST) with less than a 20% decrease over four days) or dilated CBD (defined as above) 4. chronic pancreatitis 5. estimated life expectancy \< 12 months 6. ERCP is contraindicated, e.g. the procedure cannot be carried out safely due to the patient's comorbidities or physical status; high risk of bleeding or contraindication of the discontinuation of the anticoagulation therapy. 7. ERCP is technically not feasible due to altered anatomy, e.g., total gastrectomy, Roux-en-Y gastric bypass anatomy 8. pancreatobiliary malignancy