Which of the following medical procedures has/have been associated with an increased risk of post-procedure acute pancreatitis?

a. Common bile duct exploration

b. Endoscopic retrograde cholangiopancreatography

c. Coronary bypass grafting 

d. Distal gastrectomy 

Many surgical procedures in the upper abdomen are associated with postoperative pancreatitis. The incidence of acute pancreatitis after gastric resection ranges from 0.6% to 1.23%. After biliary tract surgery, particularly after common bile duct exploration itself, acute pancreatitis occurs with an incidence of 0.5% to 3%. Direct manipulation or retraction of the pancreas or pancreatic duct appears to be the most common cause. About 1% of patients develop acute pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP). This is a predictable event, and the risk can be minimized by limiting the pressure used for contrast injection of the pancreatic duct. Acute pancreatitis also occurs in patients after coronary artery bypass surgery and a variety of other procedures remote from the pancreas. Although pancreatitis in this circumstance is thought to result from ischemia, hypotension is not always noted. The systemic consequences of activation of the inflammatory system may contribute to changes in microvascular blood flow.