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Post-endoscopic retrograde cholangiopancreatography(ERCP) pancreatitis (PEP)remains the most frequent adverse event of ERCP. Rectal indomethacin, as one kind of classic NSAIDs, has been proved to be effective in reducing the incidence of PEP. It has been widely used to prevent PEP in patients, especially those with potentially high risks of PEP. However, rectal indomethacin can not completely eradicate the occurrence of PEP. The rate of PEP in patients receiving indomethacin ranges from 3.2% to 9.2%. The risk factors of PEP in patients receiving rectal indomethacin remains unclear. The aim of the study was to identify potential risk factors in high-risk patients whose received administration of prophylactic rectal indomethacin after ERCP.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Indomethacin Group | All the patients with high risks of PEP received administration of one single dose of 100mg rectal indomethacin after ERCP. Patients were considered high risk of PEP if they met one of the following criteria: clinical suspicion of sphincter of Oddi dysfunction, a history of PEP, pancreatic sphincterotomy, precut sphincterotomy, ≥8 cannulation attempts, cannulation time≥10 minutes; pneumatic dilatation of an intact biliary sphincter, ≥3 inadvertent pancreatic duct cannulation, opacification of pancreatic acini, or the acquisition of a cytologic specimen from the pancreatic duct with the use of a brush or forceps. |
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| Measure | Description | Time Frame |
|---|---|---|
| Overall PEP rate | PEP was defined if patients experienced abdominal pain for more than 24h after procedure, accompanying with amylase or lipase ≥ 3 times equal to the upper limit of normal value. | 1 year |
| Measure | Description | Time Frame |
|---|---|---|
| The rate of moderate-severe pancreatitis | 1 year | |
| Overall ERCP-related complication rate | 1 year |
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Inclusion Criteria:
Exclusion Criteria:
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Patients who underwent ERCP and received administration of rectal indomethacin.
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| Name | Affiliation | Role |
|---|---|---|
| Yanglin Pan | Xijing Hospital of Disgestive Diseases.The Fourth Military University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department of gastroenterology,Chinese PLA 174 Hospital | Xiamen | Fujian | China | |||
| The First Affiliated Hospital of Xi'an Jiaotong University |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 25148137 | Background | Dumonceau JM, Andriulli A, Elmunzer BJ, Mariani A, Meister T, Deviere J, Marek T, Baron TH, Hassan C, Testoni PA, Kapral C; European Society of Gastrointestinal Endoscopy. Prophylaxis of post-ERCP pancreatitis: European Society of Gastrointestinal Endoscopy (ESGE) Guideline - updated June 2014. Endoscopy. 2014 Sep;46(9):799-815. doi: 10.1055/s-0034-1377875. Epub 2014 Aug 22. | |
| 24099466 |
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| Xi'an |
| Shaanxi |
| China |
| Xijing Hospital of Digestive Diseases | Xi'an | Shaanxi | China |
| Background |
| Yaghoobi M, Rolland S, Waschke KA, McNabb-Baltar J, Martel M, Bijarchi R, Szego P, Barkun AN. Meta-analysis: rectal indomethacin for the prevention of post-ERCP pancreatitis. Aliment Pharmacol Ther. 2013 Nov;38(9):995-1001. doi: 10.1111/apt.12488. Epub 2013 Sep 16. |
| 29980976 | Derived | Kang X, Zheng L, Zeng W, Yang S, Sun H, Zhang R, Wang X, Wang B, Tao Q, Yao S, Chen J, Pan Y, Guo X. Risk Factors for Post-ERCP Pancreatitis in High-Risk Patients Receiving Post-procedure Rectal Indomethacin. J Gastrointest Surg. 2018 Nov;22(11):1903-1910. doi: 10.1007/s11605-018-3864-0. Epub 2018 Jul 6. |