Use a Suppository to Prevent Post-ERCP Pancreatitis

Data from a network meta-analysis showed a 50% lower risk for pancreatitis with use of a rectally administered NSAID than with placement of pancreatic duct stents.

A common approach to preventing pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP) in high-risk patients (e.g., patients undergoing sphincter of Oddi manometry or ampullectomy) is placement of small-caliber pancreatic duct stents (Gastrointest Endosc Clin N Am 2012; 22:567). However, this procedure is not always feasible and may require repeat endoscopy for removal. Recent trials have demonstrated efficacy of a nonsteroidal anti-inflammatory drug (NSAID) suppository in preventing post-ERCP pancreatitis (PEP). Now, investigators have directly compared the efficacy of the two interventions for the first time using a systematic review and network meta-analysis involving 29 trials — 22 of pancreatic duct stents and 7 of re…

Reviewing Author

Chris E. Forsmark, MD

Disclosures

Editorial boardsAmerican Journal of Gastroenterology; Gut; Pancreas

Chris E. Forsmark, MD

Disclosures

Editorial boardsAmerican Journal of Gastroenterology; Gut; Pancreas

Use a Suppository to Prevent Post-ERCP Pancreatitis

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Reviewing Author