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World J Gastroenterol. 2012 Aug 21;18(31):4082-5. doi: 10.3748/wjg.v18.i31.4082.

Indomethacin for post-endoscopic retrograde cholangiopancreatography pancreatitis prophylaxis: is it the magic bullet?

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  • 1Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Florida, Gainesville, FL 32610, USA.

Abstract

Acute pancreatitis is a common complication of endoscopic retrograde cholangiopancreatography (ERCP). Pancreatic duct stent insertion after ERCP has been widely accepted as the standard of care for the prevention of this complication in high-risk patients. Unfortunately, the placement of pancreatic stents requires higher level of endoscopic expertise and is not always feasible due to anatomic considerations. Therefore, effective non-invasive pharmacologic prophylaxis remains appealing, particularly if it is inexpensive, easily administered, has a low risk side effect profile and is widely available. There have been multiple studies evaluating potential pharmacologic candidates for post-ERCP pancreatitis (PEP) prophylaxis, most of them yielding disappointing results. A recently published large, multi-center, randomized controlled trial reported that in high risk patients a single dose of rectal indomethacin administered immediately after the ERCP significantly decreased the incidence of PEP compare to placebo.

KEYWORDS:

Acute pancreatitis; Indomethacin; Non-steroidal anti-inflammatory drugs; Post-endoscopic retrograde cholangiopancreatography pancreatitis

PMID:
22919238
[PubMed - indexed for MEDLINE]
PMCID:
PMC3422786
Free PMC Article
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