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Rectal Indomethacin Doesn't Prevent Post-ERCP Pancreatitis

Indomethacin no benefit for patients undergoing endoscopic retrograde cholangiopancreatography


THURSDAY, April 7, 2016 (HealthDay News) -- For patients undergoing endoscopic retrograde cholangiopancreatography (ERCP), rectal indomethacin does not prevent the development of post-ERCP pancreatitis (PEP), according to a study published in the April issue of Gastroenterology.

John M. Levenick, M.D., from the Penn State Hershey Medical Center, and colleagues conducted a prospective trial of 449 patients undergoing ERCP (about 70 percent at average risk for PEP). Patients were randomized to a single dose of rectal indomethacin or a placebo suppository (223 and 226 patients, respectively). Patients were followed for the primary outcome of the development of PEP.

The researchers found that 7.2 and 4.9 percent of patients in the indomethacin and placebo groups, respectively, developed PEP (P = 0.33). Between the groups, complications and the severity of PEP were similar. The study was stopped early owing to futility per a priori protocol guidelines.

"In a randomized controlled study of consecutive patients undergoing ERCP, rectal indomethacin did not prevent post-ERCP pancreatitis," the authors write.

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