Pancreatitis can be a major complication of diagnostic and therapeutic ERCP.
Therefore, efforts have been made to identify ways of reducing the frequency and severity of post-ERCP pancreatitis. It is possible that corticosteroids may be effective in this regard.
In this study, researchers from the United States determined whether prophylactic, orally administered corticosteroid reduced the frequency and/or severity of post-ERCP pancreatitis.
The researchers randomized 1115 patients to receive either prednisone (40 mg), or a placebo, orally 15 hours and 3 hours before ERCP.
- corticosteroid = 17%
- control = 14%
They prospectively collected data on patients undergoing diagnostic or therapeutic ERCP at 15 centers.
In addition, the team used standardized criteria to diagnose and grade the severity of postprocedure pancreatitis.
The researchers found that the overall frequency of pancreatitis was 15%.
In the corticosteroid group 17% of patients developed post-ERCP pancreatitis, compared with 14% in the control group.
Overall, the team found that pancreatitis was mild in 10%, moderate in 4%, and severe in 1%.
However, they were unable to identify any difference in severity between the groups.
Furthermore, the researchers determined that both groups were similar with regard to a large number of variables.
Dr Stuart Sherman's team concluded, "Prophylactic orally administered corticosteroid did not reduce the frequency or severity of post-ERCP pancreatitis".