Abstract

English

Highlights

  • Nonsteroidal anti-inflammatory drugs (NSAIDs), administered rectally, seem to be effective in reducing post-ERCP pancreatitis (PEP)

  • In clinical practice about 40% of patients undergoing ERCP complain of abdominal pain after the procedure [1]. This may be a consequence of bowel distension, but some studies have shown that it could be an early predictor of post-ERCP pancreatitis (PEP) [2]

  • The aim of the present study was to assess whether intravenous ketorolac given early as an analgesic to patients with post-procedural abdominal pain lowered the rate of post-ERCP pancreatitis (PEP) in comparison with patients without post-procedural pain who were not given the drug

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Summary

Introduction

Nonsteroidal anti-inflammatory drugs (NSAIDs) (e.g. indomethacin), administered rectally, seem to be effective in reducing post-ERCP pancreatitis (PEP). This effect seems lost with intramuscularly or intravenously administration. Several prospective randomized controlled trials and meta-analyses have shown both diclofenac and indomethacin to be effective for the prevention of PEP [7,8,9,10,11,12] Based on these data recent European guidelines recommend the routine rectal administration of 100 mg of diclofenac or indomethacin in all patients, if there are no contraindications, immediately before or after ERCP to reduce the risk of PEP [8]. A recent randomized controlled trial showed that rectal indomethacin was ineffective for PEP prevention [13]

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