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Efficacy and safety of rectal indomethacin suppositories in reducing incidence of post-endoscopic retrograde cholangiopancreatography pancreatitis(PEP) among high-risk patients |
YANG Hongqi,HONG Lili,GUO YAN Fang,PENG Hui,KE Youli ZHANG Xuelan, SHI Junchao,and CAO Jifan |
Department of Gastroenterology,Anhui Provincial Corps Hospital of Chinese People’s Armed Police Force,Hefei 230041,China |
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Abstract Objective To evaluate the efficacy of rectal administration of indomethacin in reducing the incidence of post-ERCP pancreatitis among high-risk patients.Methods From March 2015 to November 2017,a total of 293 patients at high risk of PEP were randomly divided into the observation group(146) and the control group(147). Both groups received rectal indomethacin and placebo respectively 30 minutes before ERCP.The incidences of PEP and hyperamylasemia were compared between the two groups.Results The incidence of PEP was 4.11%(6/146)in the indomethacin group and 18.37%(27/147) in the placebo group(P<0.01).There was one case of severe pancreatitis among the six cases of PEP in the observation group and six cases of severe pancreatitis among the twenty-seven cases of PEP in the control group,respectively.On the basis of these results,it was calculated that the absolute risk was reduced by 14%,while the relative risk was reduced by 78%.There was significant difference in serum amylase levels and the incidence of hyperamylasemia between the two groups 24h after ERCP(P<0.01).Conclusions Rectal administration of indomethacin can significantly reduce the risk of PEP among high-risk patients.
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Received: 07 October 2018
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