Lactated Ringer's Solution to Prevent Post-ERCP Pancreatitis

Inclusion criteria

i. Possession of one of the following criteria which places the patient at high risk for post-ERCP pancreatitis and/or if patient is to undergo a planned endoscopic intervention deemed at high risk:

• Suspicion of Oddi dysfunction
• Personal history of post-ERCP pancreatitis
• More than 8 cannulation attempts
• Precut sphincterotomy
• Endoscopic papillary balloon dilation of an intact sphincter
• Endoscopic pancreatic duct sphincterotomy
• Ampullectomy
• Total bilirubin < 1.0

ii. Or possession of two or more of the following minor criteria:

• Female sex
• Age under 50 years
• Personal history of recurrent acute pancreatitis
• Pancreatic duct injection leading to "acinarization" or over 3 pancreatic duct injections
• Pancreatic duct cytology acquisition

Exclusion criteria

• Patients aged less than 18
• Inability to provide informed consent
• Pregnancy
• Active acute pancreatitis
• Any contraindication to aggressive IVF hydration: evidence of clinical volume overload (peripheral or pulmonary edema), respiratory compromise (oxygen saturation < 90% on room air), chronic kidney disease (creatinine clearance < 40 mL/min), systolic congestive heart failure (ejection fraction < 45%), cirrhosis, and severe electrolyte disturbance with sodium <130 mEq/L or >150 mEq/L
• If patient does not undergo a planned high-risk intervention
• If patient does not possess complete criteria which places them at high risk for post-ERCP pancreatitis
• Patients with cholangitis
• Patients with chronic and/or active pancreatitis
• Patients with a true NSAID allergy
• Patients greater than or equal to 75 years old