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Is rectal indomethacin effective in preventing of post-endoscopic retrograde cholangiopancreatography pancreatitis?
World J Gastroenterol 2014; 20(29):10151-7WJ

Abstract

AIM

To investigate the effectiveness of rectally administered indomethacin in the prophylaxis of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis and hyperamylasaemia in a multicentre study.

METHODS

A prospective, randomised, placebo-controlled multicentre study in five endoscopic units was conducted on 686 patients randomised to receive a suppository containing 100 mg indomethacin, or an inert placebo, 10-15 min before ERCP. Post-ERCP pancreatitis and hyperamylasaemia were evaluated 24 h following the procedure on the basis of clinical signs and laboratory parameters, and computed tomography/magnetic resonance imaging findings if required.

RESULTS

Twenty-one patients were excluded because of incompleteness of their data or because of protocol violation. The results of 665 investigations were evaluated: 347 in the indomethacin group and 318 in the placebo group. The distributions of the risk factors in the two groups did not differ significantly. Pancreatitis developed in 42 patients (6.3%): it was mild in 34 (5.1%) and severe in eight (1.2%) cases. Hyperamylaesemia occurred in 160 patients (24.1%). There was no significant difference between the indomethacin and placebo groups in the incidence of either post-ERCP pancreatitis (5.8% vs 6.9%) or hyperamylasaemia (23.3% vs 24.8%). Similarly, subgroup analysis did not reveal any significant differences between the two groups.

CONCLUSION

100 mg rectal indomethacin administered before ERCP did not prove effective in preventing post-ERCP pancreatitis.

Authors+Show Affiliations

Zoltán Döbrönte, Miklós Ihász, Lilla Lakner, Department of Gastroenterology and Internal Medicine, Markusovszky Teaching Hospital, H-9700 Szombathely, Hungary.Zoltán Döbrönte, Miklós Ihász, Lilla Lakner, Department of Gastroenterology and Internal Medicine, Markusovszky Teaching Hospital, H-9700 Szombathely, Hungary.Zoltán Döbrönte, Miklós Ihász, Lilla Lakner, Department of Gastroenterology and Internal Medicine, Markusovszky Teaching Hospital, H-9700 Szombathely, Hungary.Zoltán Döbrönte, Miklós Ihász, Lilla Lakner, Department of Gastroenterology and Internal Medicine, Markusovszky Teaching Hospital, H-9700 Szombathely, Hungary.Zoltán Döbrönte, Miklós Ihász, Lilla Lakner, Department of Gastroenterology and Internal Medicine, Markusovszky Teaching Hospital, H-9700 Szombathely, Hungary.Zoltán Döbrönte, Miklós Ihász, Lilla Lakner, Department of Gastroenterology and Internal Medicine, Markusovszky Teaching Hospital, H-9700 Szombathely, Hungary.Zoltán Döbrönte, Miklós Ihász, Lilla Lakner, Department of Gastroenterology and Internal Medicine, Markusovszky Teaching Hospital, H-9700 Szombathely, Hungary.Zoltán Döbrönte, Miklós Ihász, Lilla Lakner, Department of Gastroenterology and Internal Medicine, Markusovszky Teaching Hospital, H-9700 Szombathely, Hungary.Zoltán Döbrönte, Miklós Ihász, Lilla Lakner, Department of Gastroenterology and Internal Medicine, Markusovszky Teaching Hospital, H-9700 Szombathely, Hungary.Zoltán Döbrönte, Miklós Ihász, Lilla Lakner, Department of Gastroenterology and Internal Medicine, Markusovszky Teaching Hospital, H-9700 Szombathely, Hungary.

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25110443

Citation

Döbrönte, Zoltán, et al. "Is Rectal Indomethacin Effective in Preventing of Post-endoscopic Retrograde Cholangiopancreatography Pancreatitis?" World Journal of Gastroenterology, vol. 20, no. 29, 2014, pp. 10151-7.
Döbrönte Z, Szepes Z, Izbéki F, et al. Is rectal indomethacin effective in preventing of post-endoscopic retrograde cholangiopancreatography pancreatitis? World J Gastroenterol. 2014;20(29):10151-7.
Döbrönte, Z., Szepes, Z., Izbéki, F., Gervain, J., Lakatos, L., Pécsi, G., ... Czakó, L. (2014). Is rectal indomethacin effective in preventing of post-endoscopic retrograde cholangiopancreatography pancreatitis? World Journal of Gastroenterology, 20(29), pp. 10151-7. doi:10.3748/wjg.v20.i29.10151.
Döbrönte Z, et al. Is Rectal Indomethacin Effective in Preventing of Post-endoscopic Retrograde Cholangiopancreatography Pancreatitis. World J Gastroenterol. 2014 Aug 7;20(29):10151-7. PubMed PMID: 25110443.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Is rectal indomethacin effective in preventing of post-endoscopic retrograde cholangiopancreatography pancreatitis? AU - Döbrönte,Zoltán, AU - Szepes,Zoltán, AU - Izbéki,Ferenc, AU - Gervain,Judit, AU - Lakatos,László, AU - Pécsi,Gyula, AU - Ihász,Miklós, AU - Lakner,Lilla, AU - Toldy,Erzsébet, AU - Czakó,László, PY - 2014/01/12/received PY - 2014/03/12/revised PY - 2014/04/21/accepted PY - 2014/8/12/entrez PY - 2014/8/12/pubmed PY - 2015/5/20/medline KW - Endoscopic retrograde cholangiopancreatography KW - Hyperamylasaemia KW - Indomethacin KW - Non-steroidal anti-inflammatory drugs KW - Post-endoscopic retrograde cholangiopancreatography pancreatitis SP - 10151 EP - 7 JF - World journal of gastroenterology JO - World J. Gastroenterol. VL - 20 IS - 29 N2 - AIM: To investigate the effectiveness of rectally administered indomethacin in the prophylaxis of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis and hyperamylasaemia in a multicentre study. METHODS: A prospective, randomised, placebo-controlled multicentre study in five endoscopic units was conducted on 686 patients randomised to receive a suppository containing 100 mg indomethacin, or an inert placebo, 10-15 min before ERCP. Post-ERCP pancreatitis and hyperamylasaemia were evaluated 24 h following the procedure on the basis of clinical signs and laboratory parameters, and computed tomography/magnetic resonance imaging findings if required. RESULTS: Twenty-one patients were excluded because of incompleteness of their data or because of protocol violation. The results of 665 investigations were evaluated: 347 in the indomethacin group and 318 in the placebo group. The distributions of the risk factors in the two groups did not differ significantly. Pancreatitis developed in 42 patients (6.3%): it was mild in 34 (5.1%) and severe in eight (1.2%) cases. Hyperamylaesemia occurred in 160 patients (24.1%). There was no significant difference between the indomethacin and placebo groups in the incidence of either post-ERCP pancreatitis (5.8% vs 6.9%) or hyperamylasaemia (23.3% vs 24.8%). Similarly, subgroup analysis did not reveal any significant differences between the two groups. CONCLUSION: 100 mg rectal indomethacin administered before ERCP did not prove effective in preventing post-ERCP pancreatitis. SN - 2219-2840 UR - https://www.unboundmedicine.com/medline/citation/25110443/Is_rectal_indomethacin_effective_in_preventing_of_post_endoscopic_retrograde_cholangiopancreatography_pancreatitis L2 - http://www.wjgnet.com/1007-9327/full/v20/i29/10151.htm DB - PRIME DP - Unbound Medicine ER -