Applied occasion of indomethacin on preventing post-endoscopic retrograde cholangiopancreatography pancreatitis
10.3760/cma.j.issn.1007-5232.2018.10.004
- VernacularTitle:吲哚美辛预防经内镜逆行胰胆管造影术后胰腺炎使用时机探讨
- Author:
Yunxiao LYU
1
;
Yunxiao CHENG
;
Jiang HE
;
Bin WANG
;
Liang CHEN
;
Sicong ZHAO
;
Yali DU
;
Yundan ZHANG
Author Information
1. 322100,浙江省东阳市人民医院肝胆外科
- Keywords:
Indomethacin;
Cholangiopancreatography;
endoscopic retrograde;
Pancreatitis;
Hyperamlasemia;
Prevention
- From:
Chinese Journal of Digestive Endoscopy
2018;35(10):713-717
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the optimal timing of indomethacin administration on prevention of post-endoscopic retrograde cholangiopancreatography ( ERCP ) pancreatitis. Methods The patients were randomly divided into the preoperative group and the postoperative group, and given 100 mg indomethacin in rectum within 30 min before and after ERCP, respectively. The serum levels of amylase and lipase were measured preoperatively and 4 h, 24 h postoperatively. The incidences of postoperative complications such as acute pancreatitis, hyperamylasemia, gastrointestinal bleeding, and perforation were assessed. Results A total of 340 patients were enrolled in this study from June 2014 to June 2017. The preoperative group consisted of 163 patients, including 11 cases ( 6. 75％) with post-ERCP pancreatitis ( PEP ) and 32 cases ( 19. 63％) with hyperamylasemia. Meanwhile, 177 patients constituted the postoperative group, with 25 cases ( 14. 12％) with PEP and 55 cases ( 31. 07％) with hyperamylasemia. The incidences of PEP and hyperamylasemia were significantly lower in the preoperative group than that in the postoperative group ( P = 0. 027 and P = 0. 016, respectively ) . Conclusion Preoperative use of indomethacin can better reduce the incidence of PEP than postoperative administration, without incidence increase of other complications.
