Effects Of NSAIDs In Preventing Post-ERCP Pancreatitis

Objective1、 To investigate the preventive effects of indomethacinsuppositories via rectum on hyperamylasemia and pancreatitis afterERCP (endoscopic retrograde cholangiopancreatography).2、To investigate indomethacin combined with different diseases andvarious operations and the incidence of PEP correlation.Methods1、During August2014to December2014, I selected various patientstreated with ERCP and provided them the corresponding processing ofthe design.2、According to the inclusion criteria,103patients with common bileduct stones or obstructive jaundice were divided into two groups.Therewere53patients in the preventive group, and50patients in the controlgroup.All patients keep fasting before ERCP and all were intravenousanesthesia.lOOmg of indomethac in suppositories was administered viarectum in the preventive group30minutes after ERCP, while noindomethacin suppositories was given in the control group. Serumamylase was detected6hours and24hours after the operation. Theoccurrence of hyperamylasemia(Serum amylase>100U/L)and post-ERCPpancreatitis (PEP Abdominal with Serum amylase>300U/L) was alsoobserved. 3、Recording the recovery of patients’ between different diseases andvarious operations and analyze the correlation between the PEP andNSAIDs.Results1、All patients were successfully completed operation.The serumamylase-levels of6and24hours after ERCP in preventive groups were（125.76±89.23)、(130.16±92.31), were lower than those of controlgroup（s135.74士46.32)、(139.61±54.73)(P<0.05).4cases with PEP wasobserved in preventive group（7.54%）,while9cases with PEP occurredamong the control group（18%）.There was a difference around twogroups.(P<0.05).2、Around103patients,7common bile duct stones patients withhyperamylasemia was observed in preventive group（13.2%）,while15common bile duct stones patients with hyperamylasemia was observed incontrol group（30.0%）,was statistically difference(P=0.018),but there wasno significant difference.6obstructive jaundice patients withhyperamylasemia was observed in preventive group（11.3%）,while9obstructive jaundice patients with hyperamylasemia was observed incontrol group（13.0%）,there was no statistically difference.(P=0.319)Conclusion1、Rectal use of indomethacin suppositories can effectively decreasethe occurrence of post-ERCP pancreatitis and hyperamylasemia in patients after ERCP.2、Compared with virous dieases，drugs for patients with commonbile duct stones have a better effect in the prevention of hyperamylasemiathan patients who with obstructive jaundice.3、 Compared with operation process, the EST combined withballoon dilatation may have high blood amylase or lead to PEP comparedto single EST or balloon dilatation.there was a high probably amylaseincreases when the operation become more difficulty and complex.