Comparison of post ERCP pancreatitis and Bleeding with Diclofenac suppository and Acetaminophen suppository in patients with CBD stone

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 anti-inflammatory drugs before ERCP could reduce risk of pancreatitis after ERCP. In this study we attempted to investigate the preventive effects of non- steroid anti-inflammatory drugs (Diclofenac) on pancreatitis and bleeding after ERCP in patient with CBD stone.
The study was double-blind randomized clinical trial of 160 patients who had ERCP due to common duct stones. Two 80-person groups were randomly allocated . The control group received Acetaminophen suppository and study group received Diclofenac suppository before ERCP. Based on clinical and laboratory findings of pancreatitis and bleeding, their occurrence were studied after ERCP.
In study group 9 patients had mild pancreatitis and severe pancreatitis was not found in any of them. In control group 11 patients had mild pancreatits and two cases had severe acute pancreatitis.
In control group the mean hemoglobin level before ERCP was 12.65 ±1.68 , 24 hour after ERCP was12.69 ± 1.53 and one week after was 12.68 ± 1.53 . In Study group the mean hemoglobin level before ERCP was 12.06 ± 1.73 , in 24 houre after ERCP was 12.15 ± 1.63 and one week after ERCP was 12.36 ±1.5 . The mean of hemoglobin level in one week after ERCP in Tow group did not differ statistically ( p-value = 0.176; Z= 1.355).
Although in study group any severe pancreatitis after ERCP was not observed , but no statistically significant difference between the two groups in the incidence of pancreatitis wasnot seen. Diclofenac administered after ERCP had no effect on the incidence of bleeding complications