Acute pancreatitis following ERCP is an opportunity for prophylaxis and early modification of the disease process. This is because the initial triggering event is well defined and takes place in hospital.
In this study, researchers from Scotland determined whether rectal diclofenac reduced the incidence of pancreatitis following cholangiopancreatography.
They performed a prospective, single-center, randomized, double-blind controlled trial.
- diclofenac group = 6%
- placebo group = 15%
The team included 220 patients in the study, who had either undergone ERCP or who had manometrically verified sphincter of Oddi hypertension.
Immediately after endoscopy, patients were given a suppository containing either 100 mg diclofenac (n = 110) or placebo.
The team estimated serum amylase levels and performed a clinical evaluation in all patients.
The researchers found that 6% of patients in the diclofenac group developed pancreatitis, compared with 15% in the placebo group.
Dr Bill Murray's team concluded, "This trial shows that rectal diclofenac given immediately after ERCP can reduce the incidence of acute pancreatitis".