Clinical-liver, pancreas, and biliary tractDiclofenac reduces the incidence of acute pancreatitis after endoscopic retrograde cholangiopancreatography
Section snippets
Patients and methods
The study described in this report was approved by the ethics committee of Glasgow Royal Infirmary University National Health Service Hospitals Trust. Adult patients without clinical or biochemical evidence of acute or severe chronic pancreatitis due to undergo ERCP under the care of 3 experienced endoscopists (B.M., R.C., and C.I.) were asked to give informed consent to participate in the study. Patients were excluded if they had any contraindications to receiving diclofenac or had taken an
Results
A total of 220 patients entered the study; 110 received 100 mg diclofenac per rectum (diclofenac group), and 110 received an inert suppository (control group). There were 69 women in the diclofenac group and 74 women in the control group. The patients were well matched in regard to age (mean ± SDM; diclofenac group, 55 ± 15 years; control group, 58 ± 14 years). Table 1, Table 2 show that the 2 groups were well matched for diagnoses, procedures performed, and factors that might increase the
Discussion
We have shown that a single inexpensive 100-mg diclofenac suppository given immediately after ERCP can reduce the incidence of post-ERCP pancreatitis. The incidence of acute pancreatitis after ERCP varies according to the indications for the procedure, patient characteristics, and type of intervention performed. It is perhaps optimistically reported as 1%–2% for diagnostic ERCP, 1%–4% for endoscopic sphincterotomy, 4%–8% for pancreatic sphincterotomy, and 8%–11% for sphincterotomies in patients
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