ObjectiveTo investigate the incidence and risk factors for endoscopic retrograde cholangiopancreatography (ERCP)-related adverse events in patients with primary sclerosing cholangitis (PSC). MethodsThis study included 72 patients who were diagnosed with PSC by magnetic resonance cholangiopancreatography and underwent ERCP in the Third Hospital of Xingtai City from December 2009 to December 2013. The incidence of postoperative adverse events within 30 d after ERCP was monitored and recorded. Univariate and multivariate logistic regression analyses were used to analyze the risk factors for ERCP-related adverse events in PSC patients. ResultsThe success rate of ERCP was 94.4% (68/72). Among all adverse events, the incidence of pancreatitis and biliary tract infection were highest (6.94% and 4.17%), while the incidence of perforation was lowest (1.38%). Univariate logistic regression analysis showed that the risk of adverse events was significantly higher in patients who underwent cholangiopancreatography and sphincterotomy than in those not undergoing these procedures (OR=13.642, P=0.017; OR=7.381, P=0.000); guide wire insertion and cholangiopancreatography also increased the incidence of adverse reactions (OR=8.042, P=0.000; OR=2.651, P=0.032). Multivariate logistic regression analysis showed that guide wire insertion (OR = 4.547, 95%CI: 1.076-12.543) and biliary sphincterotomy (OR=5.023, 95%CI: 2.643-18.321) are associated with the incidence of ERCP-related adverse events. ConclusionSphincterotomy and guide wire insertion can increase the risk of adverse events in PSC patients after ERCP.