title: Is rectal indomethacin effective in preventing of post-endoscopic retrograde cholangiopancreatography pancreatitis?
abstract: OBJECTIVE
  To investigate the effectiveness of rectally administered indomethacin in the prophylaxis of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis and hyperamylasaemia in a multicentre study.
  
  
  METHODS
  A prospective, randomised, placebo-controlled multicentre study in five endoscopic units was conducted on 686 patients randomised to receive a suppository containing 100 mg indomethacin, or an inert placebo, 10-15 min before ERCP. Post-ERCP pancreatitis and hyperamylasaemia were evaluated 24 h following the procedure on the basis of clinical signs and laboratory parameters, and computed tomography/magnetic resonance imaging findings if required.
  
  
  RESULTS
  Twenty-one patients were excluded because of incompleteness of their data or because of protocol violation. The results of 665 investigations were evaluated: 347 in the indomethacin group and 318 in the placebo group. The distributions of the risk factors in the two groups did not differ significantly. Pancreatitis developed in 42 patients (6.3%): it was mild in 34 (5.1%) and severe in eight (1.2%) cases. Hyperamylaesemia occurred in 160 patients (24.1%). There was no significant difference between the indomethacin and placebo groups in the incidence of either post-ERCP pancreatitis (5.8% vs 6.9%) or hyperamylasaemia (23.3% vs 24.8%). Similarly, subgroup analysis did not reveal any significant differences between the two groups.
  
  
  CONCLUSIONS
  100 mg rectal indomethacin administered before ERCP did not prove effective in preventing post-ERCP pancreatitis.
authors.affiliation: Zoltán Döbrönte, Miklós Ihász, Lilla Lakner, Department of Gastroenterology and Internal Medicine, Markusovszky Teaching Hospital, H-9700 Szombathely, Hungary.
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Döbrönte
authors.affiliation: Zoltán Döbrönte, Miklós Ihász, Lilla Lakner, Department of Gastroenterology and Internal Medicine, Markusovszky Teaching Hospital, H-9700 Szombathely, Hungary.
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Szepes
authors.affiliation: Zoltán Döbrönte, Miklós Ihász, Lilla Lakner, Department of Gastroenterology and Internal Medicine, Markusovszky Teaching Hospital, H-9700 Szombathely, Hungary.
authors.forename: Ferenc
authors.initials: F
authors.lastname: Izbéki
authors.affiliation: Zoltán Döbrönte, Miklós Ihász, Lilla Lakner, Department of Gastroenterology and Internal Medicine, Markusovszky Teaching Hospital, H-9700 Szombathely, Hungary.
authors.forename: Judit
authors.initials: J
authors.lastname: Gervain
authors.affiliation: Zoltán Döbrönte, Miklós Ihász, Lilla Lakner, Department of Gastroenterology and Internal Medicine, Markusovszky Teaching Hospital, H-9700 Szombathely, Hungary.
authors.forename: László
authors.initials: L
authors.lastname: Lakatos
authors.affiliation: Zoltán Döbrönte, Miklós Ihász, Lilla Lakner, Department of Gastroenterology and Internal Medicine, Markusovszky Teaching Hospital, H-9700 Szombathely, Hungary.
authors.forename: Gyula
authors.initials: G
authors.lastname: Pécsi
authors.affiliation: Zoltán Döbrönte, Miklós Ihász, Lilla Lakner, Department of Gastroenterology and Internal Medicine, Markusovszky Teaching Hospital, H-9700 Szombathely, Hungary.
authors.forename: Miklós
authors.initials: M
authors.lastname: Ihász
authors.affiliation: Zoltán Döbrönte, Miklós Ihász, Lilla Lakner, Department of Gastroenterology and Internal Medicine, Markusovszky Teaching Hospital, H-9700 Szombathely, Hungary.
authors.forename: Lilla
authors.initials: L
authors.lastname: Lakner
authors.affiliation: Zoltán Döbrönte, Miklós Ihász, Lilla Lakner, Department of Gastroenterology and Internal Medicine, Markusovszky Teaching Hospital, H-9700 Szombathely, Hungary.
authors.forename: Erzsébet
authors.initials: E
authors.lastname: Toldy
authors.affiliation: Zoltán Döbrönte, Miklós Ihász, Lilla Lakner, Department of Gastroenterology and Internal Medicine, Markusovszky Teaching Hospital, H-9700 Szombathely, Hungary.
authors.forename: László
authors.initials: L
authors.lastname: Czakó
mesh_terms: D000285:Administration, Rectal; D000368:Aged; D000369:Aged, 80 and over; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects*; D016861:Cyclooxygenase Inhibitors / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D034321:Hyperamylasemia / Q000453:epidemiology / Q000517:prevention & control; D015994:Incidence; D007213:Indomethacin / Q000008:administration & dosage*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D011446:Prospective Studies; D013488:Suppositories; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D016861:Cyclooxygenase Inhibitors; D013488:Suppositories; D007213:Indomethacin
keywords: Endoscopic retrograde cholangiopancreatography; Hyperamylasaemia; Indomethacin; Non-steroidal anti-inflammatory drugs; Post-endoscopic retrograde cholangiopancreatography pancreatitis
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