Indomethacin Cuts Incidence of Post-ERCP Pancreatitis

Single dose of indomethacin effective after endoscopic retrograde cholangiopancreatography

WEDNESDAY, April 11 (HealthDay News) -- For patients who undergo endoscopic retrograde cholangiopancreatography (ERCP), a single dose of rectal indomethacin immediately after the procedure is associated with a significantly reduced incidence of pancreatitis, according to a study published in the April 12 issue of the New England Journal of Medicine.

B. Joseph Elmunzer, M.D., from the University of Michigan Medical Center in Ann Arbor, and colleagues randomly allocated 602 patients at increased risk for post-ERCP pancreatitis to receive a single dose of rectal indomethacin or placebo immediately after the procedure.

The researchers found that 82 percent of patients had clinical suspicion of sphincter of Oddi dysfunction. Post-ERCP pancreatitis developed in significantly fewer patients in the indomethacin group than the placebo group (9.2 versus 16.9 percent). In addition, moderate-to-severe pancreatitis developed in significantly fewer patients in the indomethacin group than the placebo group (4.4 versus 8.8 percent).

"Prophylactic rectal indomethacin significantly reduced the incidence and severity of post-ERCP pancreatitis in patients at elevated risk for this complication, particularly in those with a clinical suspicion of sphincter of Oddi dysfunction," the authors write.

Several authors disclosed financial relationships with pharmaceutical, medical, and biotechnology companies.

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