Is the Combination of Rectal Diclofenac and Intravenous Ringer Lactate Superior to Individual Therapy for Prophylaxis of Post–Endoscopic Retrograde Cholangiopancreatography Pancreatitis
| Autor: | Shubham Jain, Suhas Udgirkar, Pravin Rathi, Ravi Thanage, Sanjay Chandnani, Prasanta Debnath, Samit S Jain, Sujit Nair |
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| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Diclofenac Ringer's Lactate Endocrinology Diabetes and Metabolism education Suppository Single Center Gastroenterology law.invention Endocrinology Randomized controlled trial Administration Rectal law Internal medicine Internal Medicine medicine Humans Prospective Studies Rectal diclofenac Cholangiopancreatography Endoscopic Retrograde Endoscopic retrograde cholangiopancreatography Hepatology medicine.diagnostic_test business.industry Incidence (epidemiology) Middle Aged medicine.disease Pancreatitis cardiovascular system Administration Intravenous Female business circulatory and respiratory physiology medicine.drug |
| Zdroj: | Pancreas. 50:1236-1242 |
| ISSN: | 1536-4828 0885-3177 |
| DOI: | 10.1097/mpa.0000000000001903 |
| Popis: | Methods This was single-center, open-label, randomized trial. Patients who were undergoing ERCP and who were at high risk for the development of PEP were selected for the study. Patients were randomized into 3 treatment groups: diclofenac suppository group, RL group, and a combination group. Results Eight of 57 patients (14.03%) in the diclofenac group, 9 of 57 patients (15.78%) in the RL group, and 6 of 57 patients (10.52%) in the combination group developed PEP. The incidence of PEP between the three groups was not statistically significant (P = 0.70). Serum amylase level of >252 U/L had 91.3% sensitivity and 92.6% specificity for the diagnosis of PEP. Conclusions Post-ERCP pancreatitis is usually mild to moderate 95% times. Female sex, age younger than 50 years, a benign indication of ERCP, and low bilirubin levels have higher chances of PEP. A combination of rectal diclofenac and hydration with RL does not offer better protection for PEP, as compared with individual prophylaxis. |
| Databáze: | OpenAIRE |
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