Indomethacin For Prevention Of Post-ERCP Pancreatitis

ObjectiveTo investigate the preventive effect of Rectal indomethacin for post-ERCP pancreatitis(PEP) and hyperamylasemia after endoscopic retrograde Cholangiopancreatography(ERCP). Evaluation the value of indomethacin in prevention of post-ERCP pancreatitis and hyperamylasemia. MethodsNinety-three patients who underwent ERCP were randomly divided into indomethacin and control groups, of which indomethacin group 48 cases, control group 45 cases. Both of two groups give diazepam(5-10mg) and anisodamine(10 mg) and pethidine(50mg) 10 min before ERCP.100 mg of indomethacin suppositories was administered via rectum in the preventive egroup 60 minutes before ERCP. while no indomethacin suppositories was given in the control group. Both of two groups operated by skilled endoscopists. Serum amylase levels were measured before and 3-24 hours after ERCP. Incidence of acute pancreatitis and hyperamylasemia after ERCP were compared. Results(1).Serum amylase levels of two groups before ERCP were normal, there was no statistical significance;(2).Serum amylase levels at 3 hours after ERCP, indomethacin group89.08±31.65U/L, was significantly lower than control group298.91±465.18U/L U/L(P<0.05);(3).Serum amylase levels at 24 hours after ERCP, indomethacin group 111.52±151.00U/L, was significantly lower than control group239.60±394.92U/L U/L(P<0.05);(4).The incidence of PEP in indomethacin group 6.3%(3/48) was significantly lower than that of control group 22.2%(10/45)(P=0.036);(5).The incidence of hyperamylasemia in indomethacin group 14.6%(7/48) was significantly lower than that of control group 33.3%(15/45)(P=0.05). Both of them have statistical significance. ConclusionERCP is a safe and effective method for the diagnosis and treatment of biliary and pancreatic diseases. Rectal indomethacin before ERCP can reduce the incidence of PEP and hyperamylasemia.