title: Diclofenac is associated with a reduced incidence of post-endoscopic retrograde cholangiopancreatography pancreatitis: results from a Danish cohort study.
abstract: OBJECTIVE
  The aim of this study was to assess the clinical effect of diclofenac administered as a single dose for the prevention of postprocedure pancreatitis in a consecutive series of patients who had undergone endoscopic retrograde cholangiopancreatography (ERCP).
  
  
  METHODS
  Patients with a native papilla Vateri subjected to ERCP during 2010 (control group, n = 218) and 2012 (diclofenac group, n = 182) were included. Patients with a history of chronic pancreatitis or recent acute pancreatitis were excluded. From January 2012, a rectal suppository containing 100 mg of diclofenac was administered immediately after endoscopy in all patients. The primary outcome of post-ERCP pancreatitis was assessed retrospectively by reviewing the patients' charts.
  
  
  RESULTS
  The overall incidence of post-ERCP pancreatitis was 32 (14.7%) of the 218 patients in the control group and 9 (4.9%) of the 182 patients in the diclofenac group (P = 0.002). Moderate to severe pancreatitis occurred in 22 (10.1%) of the 218 patients in the control group versus 8 (4.4%) of the 182 patients in the diclofenac group (P = 0.036).
  
  
  CONCLUSIONS
  This controlled cohort study suggests that the implementation of a single dose of 100 mg of diclofenac rectally administered significantly reduces the incidence of post-ERCP pancreatitis in an unselected material of patients with native papilla.
authors.affiliation: From the *Digestive Disease Center, Bispebjerg Hospital, University of Copenhagen, Copenhagen; †Department of Gastroenterology and Surgical Gastroenterology, Hvidovre Hospital, University Hospital Hvidovre, Hvidovre, Denmark; and ‡AstraZeneca Research and Development, Mölndal, Sweden.
authors.forename: Bonna
authors.initials: B
authors.lastname: Leerhøy
authors.forename: Andreas
authors.initials: A
authors.lastname: Nordholm-Carstensen
authors.forename: Srdan
authors.initials: S
authors.lastname: Novovic
authors.forename: Mark Berner
authors.initials: MB
authors.lastname: Hansen
authors.forename: Lars Nannestad
authors.initials: LN
authors.lastname: Jørgensen
mesh_terms: D000208:Acute Disease; D000285:Administration, Rectal; D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use*; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects*; D015331:Cohort Studies; D003718:Denmark; D004008:Diclofenac / Q000008:administration & dosage / Q000627:therapeutic use*; D004341:Drug Evaluation; D005260:Female; D006801:Humans; D015994:Incidence; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D012189:Retrospective Studies
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D004008:Diclofenac