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Acute pancreatitis is the most common complication of endoscopic retrograde cholangiopancreatography (ERCP). Administering indomethacin rectally before the procedure may lower the incidence and severity of post-ERCP pancreatitis, new research suggests.


The study involved 245 patients who received 100 mg of indomethacin in a rectal suppository and 245 who received an inert suppository immediately before a scheduled ERCP. Of the 442 who subsequently underwent ERCP, 22 (5%) developed pancreatitis. Of those 22 patients, 15 had received the placebo and 7 had received indomethacin. Those in the placebo group had a significantly higher incidence of pancreatitis that was moderate to severe.


Pancreatic duct injection is a known risk factor for post-ERCP pancreatitis. Among the 44 patients who underwent this procedure, only 1 from the indomethacin group developed pancreatitis, compared with 8 patients in the placebo group.


Researchers recommend using "this simple, cheap, and safe medication" to prevent post-ERCP pancreatitis or lessen its severity.




Sotoudehmanesh R, et al., Indomethacin may reduce the incidence and severity of acute pancreatitis after ERCP, American Journal of Gastroenterology, May 2007.