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Does rectal ketoprofen prevent post ERCP pancreatitis?
Arab J Gastroenterol. 2019 Sep; 20(3):141-144.AJ

Abstract

BACKGROUND AND STUDY AIMS

Endoscopic retrograde cholangiopancreatography (ERCP) is a commonly used procedure in the management of pancreatic and biliary diseases. Acute pancreatitis is the most common complication following ERCP. Among many medications, nonsteroidal anti-inflammatory drugs (NSAIDs) were subject of numerous trials concerning post ERCP pancreatitis (PEP) prophylaxis. By inhibiting phospholipase A2, these drugs could intervene in the pathogenesis of the disease therefore limiting its occurrence. The use of some rectal NSAIDs agents was shown, to be advantageous in preventing this complication but there were not enough data on ketoprofen. The aim of this study was to assess the efficacy of rectal ketoprofen prophylactic administration in reducing the risk of PEP.

PATIENTS AND METHODS

The study was a non randomized retrospective single center study conducted between 2014 and 2018 on 242 patients divided into control and trial group receiving 100 mg of rectal Ketoprofen 30 mins before ERCP. PEP was defined as a new or exacerbated abdominal pain, in association with an elevation of serum lipase at least three times higher than the normal upper limit within and lasting more than 24 h after the procedure requiring a re-admission or a prolongation of the hospital stay. This endpoint was determined by comparing the number of patients presenting PEP in the NSAIDs group vs. the control group using Fisher exact test, with p < 0.05 representing a significant statistical value.

RESULTS

Pancreatitis developed in 6% after ERCP, 5 of them being in the trial group and 9 in the control group. Additionally, statistical calculations showed a non significant difference between the two groups in the prevalence of PEP.

CONCLUSION

Rectal ketoprofen administration before ERCP does not have any effect in preventing pancreatitis post ERCP.

Authors+Show Affiliations

Department of Gastroenterology, University Hospital of Notre Dame De Secours Byblos, Faculty of Medicine and Sciences, Holy Spirit University of Kaslik, Lebanon. Electronic address: eliasmakhoul@chu-org.lb.Department of Gastroenterology, University Hospital of Notre Dame De Secours Byblos, Faculty of Medicine and Sciences, Holy Spirit University of Kaslik, Lebanon.Department of Gastroenterology, University Hospital of Notre Dame De Secours Byblos, Faculty of Medicine and Sciences, Holy Spirit University of Kaslik, Lebanon.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31582291

Citation

Makhoul, Elias, et al. "Does Rectal Ketoprofen Prevent Post ERCP Pancreatitis?" Arab Journal of Gastroenterology : the Official Publication of the Pan-Arab Association of Gastroenterology, vol. 20, no. 3, 2019, pp. 141-144.
Makhoul E, El Mir J, Harb M. Does rectal ketoprofen prevent post ERCP pancreatitis? Arab J Gastroenterol. 2019;20(3):141-144.
Makhoul, E., El Mir, J., & Harb, M. (2019). Does rectal ketoprofen prevent post ERCP pancreatitis? Arab Journal of Gastroenterology : the Official Publication of the Pan-Arab Association of Gastroenterology, 20(3), 141-144. https://doi.org/10.1016/j.ajg.2019.09.004
Makhoul E, El Mir J, Harb M. Does Rectal Ketoprofen Prevent Post ERCP Pancreatitis. Arab J Gastroenterol. 2019;20(3):141-144. PubMed PMID: 31582291.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Does rectal ketoprofen prevent post ERCP pancreatitis? AU - Makhoul,Elias, AU - El Mir,Joe, AU - Harb,Marc, Y1 - 2019/09/30/ PY - 2019/03/16/received PY - 2019/07/17/revised PY - 2019/09/15/accepted PY - 2019/10/5/pubmed PY - 2020/3/18/medline PY - 2019/10/5/entrez KW - ERCP KW - Ketoprofen KW - Pancreatitis SP - 141 EP - 144 JF - Arab journal of gastroenterology : the official publication of the Pan-Arab Association of Gastroenterology JO - Arab J Gastroenterol VL - 20 IS - 3 N2 - BACKGROUND AND STUDY AIMS: Endoscopic retrograde cholangiopancreatography (ERCP) is a commonly used procedure in the management of pancreatic and biliary diseases. Acute pancreatitis is the most common complication following ERCP. Among many medications, nonsteroidal anti-inflammatory drugs (NSAIDs) were subject of numerous trials concerning post ERCP pancreatitis (PEP) prophylaxis. By inhibiting phospholipase A2, these drugs could intervene in the pathogenesis of the disease therefore limiting its occurrence. The use of some rectal NSAIDs agents was shown, to be advantageous in preventing this complication but there were not enough data on ketoprofen. The aim of this study was to assess the efficacy of rectal ketoprofen prophylactic administration in reducing the risk of PEP. PATIENTS AND METHODS: The study was a non randomized retrospective single center study conducted between 2014 and 2018 on 242 patients divided into control and trial group receiving 100 mg of rectal Ketoprofen 30 mins before ERCP. PEP was defined as a new or exacerbated abdominal pain, in association with an elevation of serum lipase at least three times higher than the normal upper limit within and lasting more than 24 h after the procedure requiring a re-admission or a prolongation of the hospital stay. This endpoint was determined by comparing the number of patients presenting PEP in the NSAIDs group vs. the control group using Fisher exact test, with p < 0.05 representing a significant statistical value. RESULTS: Pancreatitis developed in 6% after ERCP, 5 of them being in the trial group and 9 in the control group. Additionally, statistical calculations showed a non significant difference between the two groups in the prevalence of PEP. CONCLUSION: Rectal ketoprofen administration before ERCP does not have any effect in preventing pancreatitis post ERCP. SN - 2090-2387 UR - https://www.unboundmedicine.com/medline/citation/31582291/Does_rectal_ketoprofen_prevent_post_ERCP_pancreatitis L2 - https://linkinghub.elsevier.com/retrieve/pii/S1687-1979(19)30075-9 DB - PRIME DP - Unbound Medicine ER -