Does the Use of Potential Pancreatotoxic Drugs Increase the Risk of Post-Endoscopic Cholangiopancreatography Pancreatitis?
Abstract
:1. Introduction
2. Materials and Methods
2.1. Definitions
2.2. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Appendix A
Class Ia | Class Ib | Class II | Class III | Class IV | |
---|---|---|---|---|---|
Acetaminophen | Azathioprine | All-trans retinoic acid | Aspirin | L-Arginine | Interferon β1a |
Acetaminophencodeine | Bortezomib | L-Asparaginase/peg asparaginase | Atorvastatin | Adefovir | Interleukin 2 |
5-Aminosalicylate | Carbamazepine | Canagliflozin | Capecitabine | Ado-traztuzumab emtansine | Ketoprofen |
Amiodarone | Clonidine | Chlorothiazide | Captopril | Albiglutide | Lacosamide |
Androgenic Anabolic steroids | Clozapine | Codeine | Ceftriaxone | Allopurinol | Lamivudine |
Arsenic trioxide | Cytosine arabinoside Dapsone | Dideoxy inosine | Celecoxib | Amitriptyline | Lamotrigine |
Cannabis | Dexamethasone Fenofibrate | Gold therapy | Chlorthalidone | Amoxicillin/clavulanate | Lanreotide autogel |
Carbimazole Cimetidine | Hydrocortisone | Hydrochlorothiazide | Ciprofloxacin | Ampicillin | Levetiracetam |
Clomiphene | 6-Mercaptopurine Methimazole | Interferon α2b/ribavirin | Clarithromycin | Anagrelide hydrochloride | Mefenamic acid |
Enalapril | Mirtazapine | Lisinopril | Cocaine | Artesunate | Micafungin sodium |
Estrogen and related products | Nelfinavir | Liraglutide | Cyclosporine | Atenolol | Miltefosine |
Furosemide | Nitrofurantoin | Meglumine antimonate | Doxycycline | Axitinib | Montelukast |
In vitro fertilization | Omeprazole | Nilotinib | Erythromycin | Benazepril | Motesanib |
Isoniazid | Paclitaxel | Olanzapine | Everolimus Exenatide | Bendroflumethiazide | Mycophenolate mofetil Naltrexone |
Losartan | Pentamidine | Prednisolone | Indomethacin | Bezafibrate | Nifuroxazide |
Methyldopa | Prednisone Propofol | Riluzole | Interferon α2b | Boceprevir | Nivolumab |
Metronidazole | Quetiapine | Sitagliptin | Irbesartan | Brentuximab vendontin | Octreotide |
Nadolol | Sodium stibogluconate | Ketorolac | Calcium carbonate | Oxacalcitriol | |
Pravastatin | Sorafenib | Metformin | kondoi | Oxyphenbutazone | |
Perindopril | Tigecycline | Metolazone | Danazol | Paromomycin | |
Procainamide | Valproic acid | Minocycline | Diclofenac | Phenolphthalein | |
Pyritinol | Valsartan | Naproxen | Dideoxycytidine | Ramipril | |
Ranitidine | Orlistat | Dimethyl fumarate | Risperidone | ||
Rosuvastatin | Pazopanib | Entecavir | Roxithromycin | ||
Saxagliptin | Phenformin | Ergotamine tartrate | Secnidazole | ||
Simvastatin | Ritonavir | Estramustine phosphate | Sertraline | ||
Sulindac | Saw palmetto | Ethacrynic acid | Stavudine | ||
Tamoxifen | Tacrolimus | Ezetimibe | Sunitinib | ||
Telaprevir | Vildagliptin | Famciclovir | Tacalcitol | ||
Tetracycline | Fluconazole | Telmisartan | |||
Trimethoprim/sulfamethoxazole | Fluvastatin | Theophylline Tinidazole | |||
Gadobenate dimeglumine | Tocilizumab Vedolizumab | ||||
(Multihance) | Vemurafenib | ||||
Glimepiride | Venlafaxine | ||||
Horsetail infusions | Vinblastine | ||||
(E. arvense) | Ziprasidone | ||||
Ibuprofen | |||||
Icodextrin | |||||
Ifosfamide Imatinib | |||||
Interferon α2a |
References
- Thaker, A.M.; Mosko, J.D.; Berzin, T.M. Post-endoscopic retrograde cholangiopancreatography pancreatitis. Gastroenterol. Rep. 2015, 3, 32–40. [Google Scholar] [CrossRef] [PubMed]
- Maitin-Casalis, N.; Neeman, T.; Thomson, A. Protective effect of advanced age on post-ERCP pancreatitis and unplanned hospitalisation. Intern. Med. J. 2015, 45, 1020–1025. [Google Scholar] [CrossRef] [PubMed]
- Serrano, J.P.R.; de Moura, D.T.H.; Bernardo, W.M.; Ribeiro, I.B.; Franzini, T.P.; Brunaldi, V.O.; Salesse, M.T.; Sakai, P.; de Moura, E. Nonsteroidal anti-inflammatory drugs versus placebo for post-endoscopic retrograde cholangiopancreatography pancreatitis: A systematic review and meta-analysis. Endosc. Int. Open 2019, 7, E477–E486. [Google Scholar] [CrossRef] [PubMed]
- Tringali, A. Post-Endoscopic Retrograde Cholangiopancreatography (ERCP) Pancreatitis. 2023. Available online: https://www.uptodate.com/contents/post-endoscopic-retrograde-cholangiopancreatography-ercp-pancreatitis (accessed on 23 October 2023).
- Buxbaum, J.L.; Freeman, M.; Amateau, S.K.; Chalhoub, J.M.; Coelho-Prabhu, N.; Desai, M.; Elhanafi, S.E.; Forbes, N.; Fujii-Lau, L.L.; Kohli, D.R.; et al. American Society for Gastrointestinal Endoscopy guideline on post-ERCP pancreatitis prevention strategies: Summary and recommendations. Gastrointest. Endosc. 2023, 97, 153–162. [Google Scholar] [CrossRef] [PubMed]
- Simons-Linares, C.R.; Elkhouly, M.A.; Salazar, M.J. Drug-Induced Acute Pancreatitis in Adults: An Update. Pancreas 2019, 48, 1263–1273. [Google Scholar] [CrossRef] [PubMed]
- Baldursdottir, M.B.; Andresson, J.A.B.; Jonsdottir, S.B.; Benediktsson, H.; Kalaitzakis, E.; Bjornsson, E.S. Ischemic Pancreatitis Is an Important Cause of Acute Pancreatitis in the Intensive Care Unit. J. Clin. Gastroenterol. 2023, 57, 97–102. [Google Scholar] [CrossRef] [PubMed]
- Raper, S.E. Acute pancreatitis secondary to dehydration: Case report and review of the literature. Am. Surg. 1999, 65, 1084–1087. [Google Scholar] [CrossRef] [PubMed]
- Barakat, M.T.; Banerjee, S. Sequential endoscopist-driven phone calls improve the capture rate of adverse events after ERCP: A prospective study. Gastrointest. Endosc. 2021, 93, 902–910. [Google Scholar] [CrossRef] [PubMed]
- Gupta, S.; Irani, M.Z.; Thomson, A. Follow-up phone calls 7 days after endoscopic retrograde cholangiopancreatography: A prospective study. J. Gastroenterol. Hepatol. 2022, 37, 184–185. [Google Scholar]
- Yuen, N.; O’Shaughnessy, P.; Thomson, A. New classification system for indications for endoscopic retrograde cholangiopancreatography predicts diagnoses and adverse events. Scand. J. Gastroenterol. 2017, 52, 1457–1465. [Google Scholar] [CrossRef] [PubMed]
- Perney, P.; Berthier, E.; Pageaux, G.-P.; Hillaire-Buys, D.; Roques, V.; Fabbro-Peray, P.; Melki, M.; Hanslik, B.; Bauret, P.; Larrey, D.; et al. Are drugs a risk factor of post-ERCP pancreatitis? Gastrointest. Endosc. 2003, 58, 696–700. [Google Scholar] [CrossRef] [PubMed]
- Biour, M.; Delcenserie, R.; Grangé, J.D.; Weissenburger, J. Drug-induced pancreatitis. First updated edition of the bibliographic database of acute pancreatitis and related drugs. Gastroenterol. Clin. Biol. 2001, 25 (Suppl. S1), 1S22–1S27. [Google Scholar] [PubMed]
- Li, N.; Tieng, A.; Novak, S.; Fernandes, A.; Jalal, P.; Akerman, M.; Sideridis, K.; Bank, S. Effects of medications on post-endoscopic retrograde cholangiopancreatography pancreatitis. Pancreatology 2010, 10, 238–242. [Google Scholar] [CrossRef] [PubMed]
- Sigounas, D.E.; Christodoulou, D.K.; Tatsioni, A.; Katsanos, K.H.; Baltayiannis, G.; Kappas, A.; Ioannidis, J.P.; Tsianos, E.V. Pancreatitis potentially associated drugs as a risk factor for post-endoscopic retrograde cholangiopancreatography pancreatitis: A prospective cohort study. Pancreas 2013, 42, 601–606. [Google Scholar] [CrossRef] [PubMed]
- Badalov, N.; Baradarian, R.; Iswara, K.; Li, J.; Steinberg, W.; Tenner, S. Drug-induced acute pancreatitis: An evidence-based review. Clin. Gastroenterol. Hepatol. 2007, 5, 648–661; quiz 644. [Google Scholar] [CrossRef] [PubMed]
- Saini, J.; Marino, D.; Badalov, N.; Vugelman, M.; Tenner, S. Drug-Induced Acute Pancreatitis: An Evidence-Based Classification (Revised). Clin. Transl. Gastroenterol. 2023, 14, e00621. [Google Scholar] [CrossRef] [PubMed]
- Tryliskyy, Y.; Bryce, G.J. Post-ERCP pancreatitis: Pathophysiology, early identification and risk stratification. Adv. Clin. Exp. Med. 2018, 27, 149–154. [Google Scholar] [CrossRef] [PubMed]
- Ding, X.; Zhang, F.; Wang, Y. Risk factors for post-ERCP pancreatitis: A systematic review and meta-analysis. Surgeon 2015, 13, 218–229. [Google Scholar] [CrossRef] [PubMed]
- Kochar, B.; Akshintala, V.S.; Afghani, E.; Elmunzer, B.J.; Kim, K.J.; Lennon, A.M.; Khashab, M.A.; Kalloo, A.N.; Singh, V.K. Incidence, severity, and mortality of post-ERCP pancreatitis: A systematic review by using randomized, controlled trials. Gastrointest. Endosc. 2015, 81, 143–149. [Google Scholar] [CrossRef] [PubMed]
Class Ia |
|
Class 1b |
|
Class II |
|
Class III |
|
Class IV |
|
Primary indications |
|
Secondary Indications |
|
Variables | All Patients | Patients Not Taking PPD (n = 132) | Patients Taking PPD (n = 312) | p Value |
---|---|---|---|---|
Age, median (IQR) | 70 (55.4–79.6) | 55 (38.2–71.3) | 73.2 (63–80.6) | 0 |
Gender, male, n (%) | 180 (40.5) | 42 (31.8) | 138 (44.2) | 0.015 |
Previous history of pancreatitis, yes, n (%) | 21 (4.7) | 5 (3.8) | 16 (5.1) | 0.539 |
ASA, n (%) | 0 | |||
1 | 27 (6.1) | 20 (15.2) | 7 (2.2) | 0 |
2 | 207 (46.6) | 71 (53.8) | 136 (43.6) | 0.061 |
3 | 173 (39) | 33 (25) | 140 (44.9) | 0 |
4 | 36 (8.1) | 8 (6.1) | 28 (9) | 0.347 |
5 | 1 (0.2) | 0 (0) | 1 (0.3) | 1 |
Year of procedure, n (%) | 0.491 | |||
2019 | 123 (27.7) | 30 (22.7) | 93 (29.8) | 0.133 |
2020 | 118 (26.6) | 34 (25.8) | 84 (26.9) | 0.906 |
2021 | 109 (24.5) | 37 (28) | 72 (23.1) | 0.279 |
2022 | 92 (20.7) | 30 (22.7) | 62 (19.9) | 0.523 |
2023 | 2 (0.5) | 1 (0.8) | 1 (0.3) | 0.507 |
In- or outpatient, outpatient, n (%) | 158 (35.6) | 57 (43.2) | 101 (32.4) | 0.03 |
Emergency procedure, yes, n (%) | 31 (7) | 6 (4.5) | 25 (8) | 0.19 |
Trainee involvement, yes, n (%) | 304 (68.5) | 85 (64.4) | 219 (70.2) | 0.229 |
Indication, n (%) | 0.016 | |||
AP | 43 (9.7) | 13 (9.8) | 30 (9.6) | 1 |
BL | 8 (1.8) | 2 (1.5) | 6 (1.9) | 1 |
CH | 72 (16.2) | 7 (5.3) | 65 (20.8) | 0 |
IL | 93 (20.9) | 29 (22) | 64 (20.5) | 0.799 |
IOC | 55 (12.4) | 22 (16.7) | 33 (10.6) | 0.084 |
PI | 22 (5) | 8 (6.1) | 14 (4.5) | 0.48 |
PIL | 124 (27.9) | 43 (32.6) | 81 (26) | 0.166 |
PL | 8 (1.8) | 2 (1.5) | 6 (1.9) | 1 |
Other | 19 (4.3) | 6 (4.5) | 13 (4.2) | 0.803 |
Procedure time, median (IQR) | 20 (13–30) | 20 (13–30.2) | 20 (13–30) | 0.459 |
Propofol dosage median (IQR) | 240 (150–385) | 250 (160–400) | 230 (140–380) | 0.317 |
Intravenous fluid given, yes, n (%) | 372 (83.8) | 114 (86.4) | 258 (82.7) | 0.372 |
Rectal NSAID, yes, n (%) | 314 (70.7) | 98 (74.2) | 216 (69.2) | 0.31 |
Periampullary diverticulum, yes, n (%) | 26 (5.9) | 4 (3) | 22 (7.1) | 0.097 |
Pre-cut sphincterotomy, yes, n (%) | 119 (26.8) | 37 (28) | 82 (26.3) | 0.704 |
PD cannulation, yes, n (%) | 129 (29.1) | 47 (35.6) | 82 (26.3) | 0.048 |
Successful biliary access, yes n (%) | 406 (91.4) | 120 (90.9) | 286 (91.7) | 0.794 |
Extraction balloon for stone, yes, n (%) | 136 (30.6) | 42 (31.8) | 94 (30.1) | 0.678 |
Biliary stent insertion, yes, n (%) | 226 (50.9) | 60 (45.5) | 166 (53.2) | 0.137 |
PD stent insertion, yes n (%) | 74 (16.7) | 25 (18.9) | 49 (15.7) | 0.4 |
Post ERCP pancreatitis, yes n (%) | 32 (7.2) | 10 (7.6) | 22 (7.1) | 0.845 |
Total No. of Patients | No. of Patients with Pancreatitis n (%) | |
---|---|---|
Overall, n (%) | 444 | 32 (7.2) |
Class Ia drug, n (%) | 172 | 13 (7.6) |
Acetaminophen | 56 | 6 (10.7) |
Acetaminophen-codeine | 4 | 0 (0) |
Furosemide | 25 | 2 (8) |
Metronidazole | 32 | 3 (9.4) |
Rosuvastatin | 26 | 4 (15.4) |
Amiodarone | 3 | 0 (0) |
Oestrogen and related products | 6 | 0 (0) |
Ranitidine | 4 | 0 (0) |
Perindopril | 30 | 1 (3.3) |
Simvastatin | 16 | 1 (6.2) |
Pravastatin | 3 | 0 (0) |
Trimethoprim/sulfamethoxazole | 3 | 0 (0) |
Class Ib drug, n (%) | 49 | 3 (6.1) |
Carbamazepine | 2 | 0 (0) |
Omeprazole | 14 | 1 (7.1) |
Clonidine | 1 | 0 (0) |
Dexamethasone | 11 | 1 (9.1) |
Mirtazapine | 3 | 0 (0) |
Fenofibrate | 6 | 0 (0) |
Propofol | 1 | 0 (0) |
Hydrocortisone | 1 | 0 (0) |
Prednisone | 3 | 0 (0) |
Quetiapine | 1 | 0 (0) |
Valproic acid | 1 | 0 (0) |
Valsartan | 9 | 1 (11.1) |
Class II drug, n (%) | 41 | 2 (4.9) |
Hydrochlorothiazide | 17 | 2 (11.8) |
Olanzapine | 3 | 0 (0) |
Prednisolone | 11 | 0 (0) |
Sitagliptin | 10 | 0 (0) |
Class III drug, n (%) | 178 | 10 (5.6) |
Aspirin | 63 | 3 (4.8) |
Atorvastatin | 50 | 5 (10) |
Ceftriaxone | 35 | 4 (11.4) |
Everolimus | 1 | 0 (0) |
Irbesartan | 42 | 2 (4.8) |
Metformin | 47 | 3 (6.4) |
Celecoxib | 9 | 0 (0) |
Doxycycline | 1 | 0 (0) |
Cyclosporine | 1 | 0 (0) |
Naproxen | 1 | 0 (0) |
Tacrolimus | 4 | 0 (0) |
Class IV drug, n (%) | 122 | 10 (8.2) |
Allopurinol | 25 | 3 (12) |
Ampicillin | 13 | 3 (23.1) |
Atenolol | 8 | 1 (12.5) |
Famciclovir | 1 | 1 (100) |
Ibuprofen | 3 | 0 (0) |
Telmisartan | 20 | 1 (5) |
Amitriptyline | 16 | 1 (6.2) |
Amoxicillin/clavulanate | 6 | 0 (0) |
Ramipril | 19 | 1 (5.3) |
Sertraline | 8 | 0 (0) |
Calcium carbonate | 5 | 0 (0) |
Diclofenac | 1 | 0 (0) |
Etecavir | 1 | 0 (0) |
Ezetimibe | 10 | 1 (10) |
Mycophenolate mofetil | 4 | 0 (0) |
Lacosamide | 1 | 0 (0) |
Levetiracetam | 1 | 0 (0) |
Venlafaxine | 7 | 1 (14.3) |
PEP with PPD | PEP without PPD | p Value | |
---|---|---|---|
Class Ia drug n (%) | 13/172 (7.6) | 19/272 (7) | 0.82 |
Class Ib drug n (%) | 3/49 (6.1) | 29/395 (7.3) | 0.756 |
Class II drug n (%) | 2/41 (4.9) | 30/403 (7.4) | 0.545 |
Class III drug n (%) | 10/178 (5.6) | 22/266 (8.3) | 0.289 |
Class IV drug n (%) | 10/122 (8.2) | 22/322 (6.8) | 0.62 |
Variables | All Patients (n = 444) | Patients without PEP (n = 412) | Patients with PEP (n = 32) | p Value |
---|---|---|---|---|
Age, median (IQR) | 70 (55.4–79.6) | 70.3 (55.4–79.8) | 66 (55.9–75.9) | 0.667 |
Gender, male, n (%) | 180/444 (40.5) | 166/412 (40.3) | 14/32 (43.8) | 0.015 |
Previous history of pancreatitis, yes, n (%) | 21 (4.7) | 5 (3.8) | 16 (5.1) | 0.712 |
ASA, n (%) | 0.459 | |||
1 | 27/444 (6.1) | 26/412 (6.3) | 1/32 (3.1) | 0.71 |
2 | 207/444 (46.6) | 187/412 (45.4) | 20/32 (62.5) | 0.068 |
3 | 173/444 (39) | 164/412 (39.8) | 9/32 (28.1) | 0.259 |
4 | 36/444 (8.1) | 34/412 (8.3) | 2/32 (6.2) | 1 |
5 | 1/444 (0.2) | 1/412 (0.2) | 0/32 (0) | 1 |
Year of procedure, n (%) | 0.041 | |||
2019 | 123/444 (27.7) | 116/412 (28.2) | 7/32 (21.9) | 0.541 |
2020 | 118/444 (26.6) | 102/412 (24.8) | 16/32 (50) | 0.003 |
2021 | 109/444 (24.5) | 104/412 (25.2) | 5/32 (15.6) | 0.288 |
2022 | 92/444 (20.7) | 88/412 (21.4) | 4/32 (12.5) | 0.363 |
2023 | 2/444 (0.5) | 2/412 (0.5) | 0/32 (0) | 1 |
In- or outpatient, outpatient, n (%) | 158/444 (35.6) | 148/412 (35.9) | 10/32 (31.2) | 0.703 |
Emergency procedure, yes, n (%) | 31/444 (7) | 29/412 (7) | 2/32 (6.2) | 1 |
Trainee involvement, yes, n (%) | 304/444 (68.5) | 281/412 (68.2) | 23/32 (71.9) | 0.844 |
Indication, n (%) | 0.012 | |||
AP | 43/444 (9.7) | 41/412 (10) | 2/32 (6.2) | 0.757 |
BL | 8/444 (1.8) | 5/412 (1.2) | 3/32 (9.4) | 0.015 |
CH | 72/444 (16.2) | 69/412 (16.7) | 3/32 (9.4) | 0.453 |
IL | 93/444 (20.9) | 87/412 (21.1) | 6/32 (18.8) | 1 |
IOC | 55/444 (12.4) | 48/412 (11.7) | 7/32 (21.9) | 0.097 |
IP | 22/444 (5) | 22/412 (5.3) | 0/32 (0) | 0.39 |
PIL | 124/444 (27.9) | 116/412 (28.2) | 8/32 (25) | 0.839 |
PL | 8/444 (1.8) | 8/412 (1.9) | 0/32 (0) | 1 |
Other | 19/444 (4.3) | 16/412 (3.9) | 3/32 (9.4) | 0.15 |
Procedure time, median (IQR) | 20 (13–30) | 20 (12–29.8) | 28 (19.8–35.8) | 0.028 |
Propofol dosage median (IQR) | 240 (150–385) | 240 (150–380) | 310 (190–470) | 0.157 |
Intravenous fluid given, yes, n (%) | 372/443 (84) | 114 (86.4) | 258 (82.7) | 0.372 |
Rectal NSAID, yes, n (%) | 314 (70.7) | 345/412 (83.7) | 27/31 (87.1) | 0.801 |
Periampullary diverticulum, yes, n (%) | 26/436 (6) | 20/404 (5) | 2/14 (14.3) | 0.01 |
Pre-cut sphincterotomy, yes, n (%) | 119/444 (26.8) | 101/412 (24.5) | 6/14 (42.9) | 0 |
PD cannulation, yes, n (%) | 129/444 (29.1) | 109/412 (26.5) | 4/14 (28.6) | 0 |
Successful biliary access, yes n (%) | 406/444 (91.4) | 377/412 (91.5) | 29/32 (90.6) | 0.747 |
Extraction balloon for stone, yes, n (%) | 136/406 (33.5) | 128/377 (34) | 8/29 (27.6) | 0.546 |
Biliary stent insertion, yes, n (%) | 226/406 (55.7) | 206/377 (54.6) | 20/29 (69) | 0.174 |
PD stent insertion, yes n (%) | 74 (16.7) | 25 (18.9) | 49 (15.7) | 0.4 |
Taking PPD, yes n (%) | 312/444 (70.3) | 290/412 (70.4) | 22/32 (68.8) | 0.842 |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Siu, W.; Ahmadzai, H.; Hasnol, M.H.; Fauzi, M.N.; Khoo, A.L.; Zhao, M.; Thomson, A. Does the Use of Potential Pancreatotoxic Drugs Increase the Risk of Post-Endoscopic Cholangiopancreatography Pancreatitis? Gastroenterol. Insights 2024, 15, 744-753. https://doi.org/10.3390/gastroent15030053
Siu W, Ahmadzai H, Hasnol MH, Fauzi MN, Khoo AL, Zhao M, Thomson A. Does the Use of Potential Pancreatotoxic Drugs Increase the Risk of Post-Endoscopic Cholangiopancreatography Pancreatitis? Gastroenterology Insights. 2024; 15(3):744-753. https://doi.org/10.3390/gastroent15030053
Chicago/Turabian StyleSiu, Wilson, Hasib Ahmadzai, Muhammad Haziq Hasnol, Muhammad Nabil Fauzi, Ash Li Khoo, Muzhi Zhao, and Andrew Thomson. 2024. "Does the Use of Potential Pancreatotoxic Drugs Increase the Risk of Post-Endoscopic Cholangiopancreatography Pancreatitis?" Gastroenterology Insights 15, no. 3: 744-753. https://doi.org/10.3390/gastroent15030053