Role of diclofenac in reducing post-endoscopic retrograde cholangiopancreatography pancreatitis

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http://www3.interscience.wiley.com/journal/120122614/abstract?CRETRY=1 & SRETRY=0

Journal of Gastroenterology and Hepatology

Volume 23 Issue 7pt2, Pages e11 - e16

Published Online: 7 Aug 2007

GASTROENTEROLOGY

Role of diclofenac in reducing post-endoscopic retrograde cholangiopancreatography pancreatitis

Manouchehr Khoshbaten,* Homayoun Khorram, † Leili Madad, † Mohammad Javad Ehsani Ardakani, † Haleh Farzin ‡ and Mohammmad Reza Zali †

*Drug Applied Research Center (DARC), ‡ Liver and Gastrointestinal Disease Research Center, Tabriz University of Medical Sciences, Tabriz and † Research Center of Gastroenterology and Liver Disease (RCGLD), Shaheed Beheshti University of Medical Sciences, Tehran, Iran

Correspondence to Dr Manouchehr Khoshbaten, Drug Applied Research Center, Research & Development Complex, Daneshgah Street, Tabriz, Iran. Email: mkhoshbaten@...

Copyright Journal compilation © 2008 Blackwell Publishing Asia Pty Ltd and Journal of Gastroenterology and Hepatology Foundation

KEYWORDS

diclofenac • pancreatitis • post-endoscopic retrograde cholangiopancreatography

ABSTRACT

Background and Aims: Acute pancreatitis following endoscopic retrograde cholangiography presents a unique opportunity for prophylaxis and early modification of the disease process because the initial triggering event is temporally well defined and takes place in the hospital. We report a prospective, single-center, randomized, double-blind controlled trial to determine if rectal diclofenac reduces the incidence of pancreatitis following cholangiopancreatography.

Methods: Entry to the trial was restricted to patients who underwent endoscopic retrograde pancreatography. Immediately after endoscopy, patients were given a suppository containing either 100 mg diclofenac or placebo. Estimation of serum amylase level and clinical evaluation were performed in all patients.

Results: One hundred patients entered the trial, and 50 received rectal diclofenac. Fifteen patients developed pancreatitis (15%), of whom two received rectal diclofenac and 13 received placebo (P < 0.01).

Conclusions: This trial shows that rectal diclofenac given immediately after endoscopic retrograde cholangiopancreatography can reduce the incidence of acute pancreatitis.

Accepted for publication 4 May 2007.

DIGITAL OBJECT IDENTIFIER (DOI)10.1111/j.1440-1746.2007.05096