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A Trial of Rectal Indomethacin to Prevent Post-ERCP Pancreatitis in Patients with Suspected Type 3 Sphincter of Oddi Dysfunction.
Dig Dis Sci. 2015 Aug; 60(8):2509-15.DD

Abstract

BACKGROUND AND AIM

Recent data have suggested that rectal indomethacin can also reduce the incidence of post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP). The aim of this study was to determine whether prophylactic rectal indomethacin with PD stenting would reduce the incidence and severity of PEP compared to PD stenting alone in patients undergoing manometry for suspected SOD type 3.

PATIENTS AND METHODS

A retrospective review of consecutive patients who underwent an ERCP with manometry for suspected SOD type 3 was performed. Patients were divided into two groups: (a) those who received a prophylactic PD stent (n = 285) and (b) those who received a prophylactic PD stent and a single dose of 100-mg indomethacin suppositories after ERCP (n = 57). The rate of PEP was compared between the two groups.

RESULTS

The two patient groups were similar with regard to patient and procedure risk factors for PEP. Post-ERCP pancreatitis developed in 22 % patients. There was no significant difference in the incidence of PEP in the PD stent group compared to the PD stent and indomethacin group (23 vs. 18 %, respectively; p = 0.39). Moderate-to-severe pancreatitis developed in 21 (7 %) patients in the PD stent group compared to 5 (9 %) patients in the PD stent and indomethacin group (p = 0.78). Among patients with PEP, the median length of hospital stay was not significantly longer in the PD stent group compared to the PD stent and indomethacin group (6 vs. 4 days, respectively; p = 0.11).

CONCLUSIONS

In patients with suspected SOD type 3, prophylactic rectally administered indomethacin with PD stenting was not observed to affect the incidence or severity of post-ERCP pancreatitis when compared to PD stenting alone.

Authors+Show Affiliations

Division of Gastroenterology and Hepatology, Department of Internal Medicine, Thomas Jefferson University Hospital, Philadelphia, PA, USA, Ali.Siddiqui@Jefferson.edu.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25868629

Citation

Siddiqui, Ali A., et al. "A Trial of Rectal Indomethacin to Prevent Post-ERCP Pancreatitis in Patients With Suspected Type 3 Sphincter of Oddi Dysfunction." Digestive Diseases and Sciences, vol. 60, no. 8, 2015, pp. 2509-15.
Siddiqui AA, Patel D, Kaplan J, et al. A Trial of Rectal Indomethacin to Prevent Post-ERCP Pancreatitis in Patients with Suspected Type 3 Sphincter of Oddi Dysfunction. Dig Dis Sci. 2015;60(8):2509-15.
Siddiqui, A. A., Patel, D., Kaplan, J., Zabolotsky, A. H., Loren, D., Kowalski, T., Ghumman, S. S., Adler, D. G., Munigal, S., Hayat, U., & Eloubeidi, M. A. (2015). A Trial of Rectal Indomethacin to Prevent Post-ERCP Pancreatitis in Patients with Suspected Type 3 Sphincter of Oddi Dysfunction. Digestive Diseases and Sciences, 60(8), 2509-15. https://doi.org/10.1007/s10620-015-3643-7
Siddiqui AA, et al. A Trial of Rectal Indomethacin to Prevent Post-ERCP Pancreatitis in Patients With Suspected Type 3 Sphincter of Oddi Dysfunction. Dig Dis Sci. 2015;60(8):2509-15. PubMed PMID: 25868629.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A Trial of Rectal Indomethacin to Prevent Post-ERCP Pancreatitis in Patients with Suspected Type 3 Sphincter of Oddi Dysfunction. AU - Siddiqui,Ali A, AU - Patel,Devi, AU - Kaplan,Jeremy, AU - Zabolotsky,Andrew H, AU - Loren,David, AU - Kowalski,Thomas, AU - Ghumman,Saad S, AU - Adler,Douglas G, AU - Munigal,Satish, AU - Hayat,Umar, AU - Eloubeidi,Mohamad A, Y1 - 2015/04/14/ PY - 2014/10/23/received PY - 2015/03/26/accepted PY - 2015/4/15/entrez PY - 2015/4/15/pubmed PY - 2015/10/1/medline SP - 2509 EP - 15 JF - Digestive diseases and sciences JO - Dig. Dis. Sci. VL - 60 IS - 8 N2 - BACKGROUND AND AIM: Recent data have suggested that rectal indomethacin can also reduce the incidence of post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP). The aim of this study was to determine whether prophylactic rectal indomethacin with PD stenting would reduce the incidence and severity of PEP compared to PD stenting alone in patients undergoing manometry for suspected SOD type 3. PATIENTS AND METHODS: A retrospective review of consecutive patients who underwent an ERCP with manometry for suspected SOD type 3 was performed. Patients were divided into two groups: (a) those who received a prophylactic PD stent (n = 285) and (b) those who received a prophylactic PD stent and a single dose of 100-mg indomethacin suppositories after ERCP (n = 57). The rate of PEP was compared between the two groups. RESULTS: The two patient groups were similar with regard to patient and procedure risk factors for PEP. Post-ERCP pancreatitis developed in 22 % patients. There was no significant difference in the incidence of PEP in the PD stent group compared to the PD stent and indomethacin group (23 vs. 18 %, respectively; p = 0.39). Moderate-to-severe pancreatitis developed in 21 (7 %) patients in the PD stent group compared to 5 (9 %) patients in the PD stent and indomethacin group (p = 0.78). Among patients with PEP, the median length of hospital stay was not significantly longer in the PD stent group compared to the PD stent and indomethacin group (6 vs. 4 days, respectively; p = 0.11). CONCLUSIONS: In patients with suspected SOD type 3, prophylactic rectally administered indomethacin with PD stenting was not observed to affect the incidence or severity of post-ERCP pancreatitis when compared to PD stenting alone. SN - 1573-2568 UR - https://www.unboundmedicine.com/medline/citation/25868629/A_Trial_of_Rectal_Indomethacin_to_Prevent_Post_ERCP_Pancreatitis_in_Patients_with_Suspected_Type_3_Sphincter_of_Oddi_Dysfunction_ L2 - https://doi.org/10.1007/s10620-015-3643-7 DB - PRIME DP - Unbound Medicine ER -