title: 25 mg versus 50 mg dose of rectal diclofenac for prevention of post-ERCP pancreatitis in Japanese patients: a retrospective study.
abstract: OBJECTIVE
  The aim of the present study was to assess the appropriate administration dose of non-steroidal anti-inflammation drugs to prevent pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP). Importantly, the 100 mg dose of diclofenac recommended in Western countries has not been permitted in Japan.
  
  
  METHODS
  A retrospective study.
  
  
  METHODS
  A single centre in Japan.
  
  
  METHODS
  This study enrolled patients who underwent ERCP at the Department of Gastroenterology, Osaka Saiseikai Senri Hospital, from April 2011 through June 2013, and who received either a 25 or a 50 mg dose of rectal diclofenac after ERCP.
  
  
  METHODS
  The occurrence of post-ERCP pancreatitis (PEP). A multivariate regression model was used to assess the effect of the 50 mg dose (the 50 mg group) of rectal diclofenac and to compare it to the occurrence of PEP referring to the 25 mg group.
  
  
  RESULTS
  A total of 155 eligible patients received either 25 mg (84 patients) or 50 mg (71 patients) doses of rectal diclofenac after ERCP to prevent PEP. The proportion of PEP was significantly lower in the 50 mg group than in the 25 mg group (15.5% (11/71) vs 33.3% (28/84), p=0.018). In a multivariate analysis, the occurrence of PEP was significantly lower in the 50 mg group than in the 25 mg group even after adjusting potential confounding factors (adjusted OR=0.27, 95% CI 0.11 to 0.70).
  
  
  CONCLUSIONS
  From this observation, the occurrence of PEP was significantly lower among ERCP patients with the 50 mg dose of rectal diclofenac than among those with the 25 mg dose.
authors: Department of Gastroenterology, Osaka Saiseikai Senri Hospital, Suita, Osaka, Japan.
authors: Takeo
authors: T
authors: Yoshihara
authors: Department of Gastroenterology, Osaka Saiseikai Senri Hospital, Suita, Osaka, Japan.
authors: Masayoshi
authors: M
authors: Horimoto
authors: Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.
authors: Tetsuhisa
authors: T
authors: Kitamura
authors: Department of Gastroenterology, Osaka Saiseikai Senri Hospital, Suita, Osaka, Japan.
authors: Naoto
authors: N
authors: Osugi
authors: Department of Gastroenterology, Osaka Saiseikai Senri Hospital, Suita, Osaka, Japan.
authors: Tatsuro
authors: T
authors: Ikezoe
authors: Department of Gastroenterology, Osaka Saiseikai Senri Hospital, Suita, Osaka, Japan.
authors: Kaori
authors: K
authors: Kotani
authors: Department of Gastroenterology, Osaka Saiseikai Senri Hospital, Suita, Osaka, Japan.
authors: Toru
authors: T
authors: Sanada
authors: Department of Gastroenterology, Osaka Saiseikai Senri Hospital, Suita, Osaka, Japan.
authors: Churi
authors: C
authors: Higashi
authors: Department of Gastroenterology, Osaka Saiseikai Senri Hospital, Suita, Osaka, Japan.
authors: Daisuke
authors: D
authors: Yamaguchi
authors: Department of Gastroenterology, Osaka Saiseikai Senri Hospital, Suita, Osaka, Japan.
authors: Makiyo
authors: M
authors: Ota
authors: Department of Gastroenterology, Osaka Saiseikai Senri Hospital, Suita, Osaka, Japan.
authors: Tatsunori
authors: T
authors: Mizuno
authors: Department of Gastroenterology, Osaka Saiseikai Senri Hospital, Suita, Osaka, Japan.
authors: Yasukazu
authors: Y
authors: Gotoh
authors: Department of Gastroenterology, Osaka Saiseikai Senri Hospital, Suita, Osaka, Japan.
authors: Yorihide
authors: Y
authors: Okuda
authors: Department of Gastroenterology, Osaka Saiseikai Senri Hospital, Suita, Osaka, Japan.
authors: Kunio
authors: K
authors: Suzuki
mesh_terms: D000285:Administration, Rectal; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects*; D004008:Diclofenac / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000209:etiology / Q000517:prevention & control*; D012189:Retrospective Studies
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D004008:Diclofenac