Year 2020 / Volume 112 / Number 3
Original
Effectiveness of rectal indomethacin in the prevention of acute pancreatitis after endoscopic retrograde cholangiopancreatography in unselected patients

183-188

DOI: 10.17235/reed.2020.6502/2019

Mayra Lindo Ricce, Teresa Rodríguez López-Salazar, Jorge Mendoza Jiménez-Ridruejo, Jose Andrés Moreno Monteagudo, Cecilio Santander Vaquero,

Abstract
Background and aims: several studies have shown that rectal indomethacin decreases the risk of acute pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP). However, in recent studies, its effectiveness is being questioned, especially in average risk patients. Our principal aim was to evaluate the efficacy of rectal indomethacin prophylaxis in the development of post-ERCP pancreatitis (PEP). Methods: a retrospective cohort study was conducted at a third-level university hospital. Data was collected from every patients who underwent ERCP between January 2014 and June 2016. After February 2015, all patients received 100 mg of rectal indomethacin prior to ERCP. We analyzed groups, with indomethacin and without indomethacin, in unselected patients. Results: a total of 524 patients were analyzed, with a mean age of 71.1 ± 17.0 (standard deviation [SD]) years. Of the total number of patients, 393 (75%) had an average risk; 277 received rectal indomethacin prior to ERCP, while 247 did not. In the group with indomethacin, 12 patients developed PEP (4.33%) versus ten in the indomethacin-free group (4.04%) (OR 1.33; 95% confidence interval [CI], 0.52-3.40; p = 0.56). Severe-moderate PEP developed in seven patients (2.52%) in the indomethacin group and in two patients (0.81%) in the indomethacin-free group (p = 0.24). Previous sphincterotomy was a protective factor (OR 0.02; 95% CI, 0.02-0.2; p = 0.001) and age < 45 years was a risk factor: (OR 3.43; 95% CI, 1.14-10.32; p = 0.03). Conclusions: rectal indomethacin does not appear to decrease the risk of developing PEP in unselected patients.
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Lindo Ricce M, Rodríguez López-Salazar T, Mendoza Jiménez-Ridruejo J, Moreno Monteagudo J, Santander Vaquero C. Effectiveness of rectal indomethacin in the prevention of acute pancreatitis after endoscopic retrograde cholangiopancreatography in unselected patients. 6502/2019


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Publication history

Received: 14/07/2019

Accepted: 01/10/2019

Online First: 05/02/2020

Published: 05/03/2020

Article revision time: 77 days

Article Online First time: 206 days

Article editing time: 235 days


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