The comparison between combination of pancreatic stent and nsaid with nsaid alone in preventing post ERCP pancreatitis

Abstract

ERCP as a diagnostic and therapeutic tool for biliary tract and pancreatic diseases is associated with many complications such as Pancreatitis, bleeding, perforation, and cardiovascular consequences. A recent survey showed that the use of non-steroid antiinflammatory drugs before ERCP could reduce risk of pancreatitis after ERCP. In order to assess this hypothesis in the patients admitted to Taleghani hospital, Tehran, Iran, with CBD stone, we designed the current study. After randomized selection and division of the patients to different groups; the patient's candidate for pancreatic duct stent (PD stent) and Indomethacin-supplement procedure and the patients under Indomethacin-supplement process alone. After evaluating different variabilities as sex, age, Post ERCP Pancreatitis (PEP) with use of PD stent, PEP with use of indomethacin-supplement and PD stent, medications, type of disease, laboratory test such as CBC, AST, ALT and bilirubin test, ERCP was conducted by one expert specialist. Blinding of the staff and analysis department was conducted as well. Data analysis showed that <10 minutes of cannulation could decrease the incidence of PEP in our study (P-value<0.05), while other variables did not manifested any correlation with the incidence of PEP. In conclusion, we showed the evidence that different interventional elements or patient associated risk factors had no significantly effect on PEP incidence. However, deep cannulation time as the important factor of procedure could alter the rate of PEP.