Diclofenac reduces the incidence of acute pancreatitis after endoscopic retrograde cholangiopancreatography.
Author(s): Murray B, Carter R, Imrie C, Evans S, O'Suilleabhain C
Affiliation(s): Lister Department of Surgery, Glasgow Royal Infirmary, Glasgow G31 2ER, Scotland, UK.
Publication date & source: 2003-06, Gastroenterology., 124(7):1786-91.
Publication type: Clinical Trial; Randomized Controlled Trial
BACKGROUND & AIMS: Acute pancreatitis following endoscopic retrograde cholangiopancreatography presents a unique opportunity for prophylaxis and early modification of the disease process because the initial triggering event is temporally well defined and takes place in the hospital. We report a prospective, single-center, randomized, double-blind controlled trial to determine if rectal diclofenac reduces the incidence of pancreatitis following cholangiopancreatography. METHODS: Entry to the trial was restricted to patients who underwent endoscopic retrograde pancreatography or had manometrically verified sphincter of Oddi hypertension. Immediately after endoscopy, patients were given a suppository containing either 100 mg diclofenac or placebo. Estimation of serum amylase levels and clinical evaluation were performed in all patients. RESULTS: A total of 220 patients entered the trial, and 110 received rectal diclofenac. Twenty-four patients developed pancreatitis (11%), of whom 7 received rectal diclofenac and 17 received placebo (P < 0.05). CONCLUSIONS: This trial shows that rectal diclofenac given immediately after endoscopic retrograde cholangiopancreatography can reduce the incidence of acute pancreatitis.
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