Role of diclofenac in reducing post-endoscopic retrograde cholangiopancreatography pancreatitis.
OBJECTIVE
Acute pancreatitis following endoscopic retrograde cholangiography 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. Immediately after endoscopy, patients were given a suppository containing either 100 mg diclofenac or placebo. Estimation of serum amylase level and clinical evaluation were performed in all patients.


RESULTS
One hundred patients entered the trial, and 50 received rectal diclofenac. Fifteen patients developed pancreatitis (15%), of whom two received rectal diclofenac and 13 received placebo (P < 0.01).


CONCLUSIONS
This trial shows that rectal diclofenac given immediately after endoscopic retrograde cholangiopancreatography can reduce the incidence of acute pancreatitis.
Khoshbaten
Manouchehr
M
Drug Applied Research Center, Research & Development Complex, Tabriz, Iran. mkhoshbaten@yahoo.com
Khorram
Homayoun
H
Madad
Leili
L
Ehsani Ardakani
Mohammad Javad
MJ
Farzin
Haleh
H
Zali
Mohammmad Reza
MR
D000208:Acute Disease; D000285:Administration, Rectal; D000328:Adult; D000368:Aged; D000681:Amylases / Q000097:blood; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use*; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects*; D004008:Diclofenac / Q000008:administration & dosage / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000201:enzymology / Q000209:etiology / Q000517:prevention & control*; D011446:Prospective Studies; D013488:Suppositories; D016896:Treatment Outcome
D000894:Anti-Inflammatory Agents, Non-Steroidal; D013488:Suppositories; D004008:Diclofenac; D000681:Amylases