Diclofenac Does Not Reduce the Risk of Post-endoscopic Retrograde Cholangiopancreatography Pancreatitis in Low-Risk Units

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Rainio , M , Lindström , O , Udd , M , Louhimo , J & Kylänpää , L 2017 , ' Diclofenac Does Not Reduce the Risk of Post-endoscopic Retrograde Cholangiopancreatography Pancreatitis in Low-Risk Units ' , Journal of Gastrointestinal Surgery , vol. 21 , no. 8 , pp. 1270-1277 . https://doi.org/10.1007/s11605-017-3412-3

Title: Diclofenac Does Not Reduce the Risk of Post-endoscopic Retrograde Cholangiopancreatography Pancreatitis in Low-Risk Units
Author: Rainio, Mia; Lindström, Outi; Udd, Marianne; Louhimo, Johanna; Kylänpää, Leena
Other contributor: University of Helsinki, II kirurgian klinikka
University of Helsinki, University of Helsinki
University of Helsinki, University of Helsinki
University of Helsinki, Clinicum
University of Helsinki, Department of Surgery




Date: 2017-08
Language: eng
Number of pages: 8
Belongs to series: Journal of Gastrointestinal Surgery
ISSN: 1091-255X
DOI: https://doi.org/10.1007/s11605-017-3412-3
URI: http://hdl.handle.net/10138/238725
Abstract: Background Nonsteroidal anti-inflammatory drugs have an inhibitory role in pathogenesis of pancreatitis. Guidelines from the European Society of Gastrointestinal Endoscopy recommend routine rectal administration of 100 mg of diclofenac or indomethacin immediately before or after ERCP for all patients without contraindications. Aims Our aim was to evaluate the effect of diclofenac in preventing post-ERCP pancreatitis (PEP) in a high-volume, low-PEP-risk ERCP unit. Methods The rate and severity of PEP were compared in groups of 1000 historical controls prior to the routine use of diclofenac and in 1000 patients receiving 100 mg diclofenac before ERCP. Results PEP occurred in 56 (2.8%) of the 2000 patients, and the rate of the pancreatitis was 2.8% in control group and 2.8% in diclofenac group (p = 1.000). The PEP rate among the native papilla patients was 3.9% in control group and 3.6% in diclofenac group (p = 0.803). In subgroup analysis of patients with a high risk of PEP, diclofenac neither prevented PEP nor made its course milder. Conclusions In an unselected patient population in a center with a low incidence of PEP, diclofenac seems to have no beneficial effect.
Subject: Acute pancreatitis
Diclofenac
ERCP
ESGE recommendation
Post-ERCP pancreatitis
NONSTEROIDAL ANTIINFLAMMATORY DRUGS
ERCP PANCREATITIS
RECTAL INDOMETHACIN
RANDOMIZED-TRIAL
METAANALYSIS
PREVENTION
COMPLICATIONS
NSAIDS
SPHINCTEROTOMY
MULTICENTER
3126 Surgery, anesthesiology, intensive care, radiology
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