title: Rectal indomethacin for the prevention of post-ERCP pancreatitis: A meta-analysis of randomized controlled trials.
abstract: OBJECTIVE
  This meta-analysis was undertaken to evaluate the effect of rectal indomethacin in the prevention of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis.
  
  
  METHODS
  Major databases including Embase, Medline, Science Citation Index Expanded, Pubmed and the Cochrane Central Register of Controlled Trials, were searched to identify all relevant studies from January 1960 to July 2013. Randomized controlled trials (RCTs) comparing prophylactic use of rectal indomethacin versus placebo were included. Risk ratio (RR) with 95% confidence interval (CI) was calculated using fixed- or random-effect models.
  
  
  RESULTS
  Three studies met the inclusion criteria and were included in the final analyses. The overall incidence of post-ERCP pancreatitis (PEP) was significantly decreased by prophylactic rectal indomethacin compared with the placebo (RR=0.51; 95% CI=0.37-0.70). The pooled incidence of moderate to severe pancreatitis was also decreased by rectal indomethacin prophylaxis (RR=0.43; 95% CI=0.23-0.80).
  
  
  CONCLUSIONS
  Rectal indomethacin can reduce the overall incidence and the severity of PEP.
authors.affiliation: Sichuan Provincial Pancreatitis Center, Integrated Traditional and Western Medicine, Chengdu, China. xiaqing@medmail.com.cn.
authors.forename: Na
authors.initials: N
authors.lastname: Shi
authors.forename: Lihui
authors.initials: L
authors.lastname: Deng
authors.forename: Kiran
authors.initials: K
authors.lastname: Altaf
authors.forename: Wei
authors.initials: W
authors.lastname: Huang
authors.forename: Ping
authors.initials: P
authors.lastname: Xue
authors.forename: Qing
authors.initials: Q
authors.lastname: Xia
mesh_terms: D000285:Administration, Rectal; D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D007213:Indomethacin / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010195:Pancreatitis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D016032:Randomized Controlled Trials as Topic
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D007213:Indomethacin