Risk Factors of Post-ERCP Pancreatitis in Patients Receiving Rectal Indomethacin

Risk Factors Related to Post-endoscopic Retrograde Cholangiopancreatography Pancreatitis in High-risk Patients Who Underwent ERCP and Received Prophylactic Rectal Indomethacin

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.

Inclusion Criteria:

• Undergoing diagnostic or interventional ERCP
• Receiving administration of rectal indomethacin(100mg) after ERCP
• High risk patients determined at the discretions of endoscopists

Exclusion Criteria:

• Dose other than 100mg
• Acute pancreatitis within 3 days before ERCP
• Average risk patients at the discretions of endoscopists
• Using NSAIDs within 7 days before ERCP
• Without cannulation attempts
• Administration of rectal indomethacin before or during ERCP