Combination of diclofenac and aggressive hydration for the prevention of post-ERCP pancreatitis
Author(s):
Article Type:
Research/Original Article (دارای رتبه معتبر)
Abstract:
Aim
To investigate whether aggressive hydration can increase the efficacy of prophylactic non-steroid anti-inflammatory drugs(NSAIDs) in prevention of post-ERCP pancreatitis.
Background
NSAIDs are recommended for the prevention of PEP; however, whether aggressive hydration can have additionalbenefits in this regard is not known.
Methods
Patients candidate for ERCP received either pre-procedural rectal diclofenac (100 mg) alone (n = 112) or in combinationwith aggressive hydration by lactate ringer’s (n = 107) as prophylactic method. PEP was defined based on increase in serum levels of
pancreatic enzymes (from baseline to 24 hours following the procedure) accompanied with symptoms.
Results
PEP was occurred in 3 patients in the diclofenac only group and in 1 patient in the diclofenac + hydration group with nosignificant difference (2.7% vs. 0.9%, P = 0.622). Serum amylase levels decreased over time in the diclofenac + hydration group but
not in the diclofenac only group. Also, serum lipase levels decreased more rapidly over time in the diclofenac + hydration group
compared to the diclofenac only group.
Conclusion
Combination prophylactic therapy with NSAIDs plus aggressive hydration does not seem to have additional clinicallyimportant benefits in preventing PEP. Studies with larger sample of patients are required in this regard.
Keywords: Pancreatitis, Endoscopic retrograde cholangiopancreatography, Prevention, Inflammation, Diclofenac, Aggressive
hydration.
(Please cite as: Hajalikhani M, Emami MH, Khodadoostan M, Shavakhi A, Rezaei M, Soluki R. Combination of
diclofenac and aggressive hydration for the prevention of post-ERCP pancreatitis. Gastroenterol Hepatol Bed
Bench 2018;11(4):319-324
Keywords:
Language:
English
Published:
Gastroenterology and Hepatology From Bed to Bench Journal, Volume:11 Issue: 4, Autumn 2018
Pages:
319 to 324
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