Effective Prophylaxis for Post-ERCP Pancreatitis

Preprocedure hydration with lactated Ringer's solution plus rectal indomethacin significantly reduced PEP risk in high-risk patients.

Vigorous periprocedural hydration with lactated Ringer's solution (LRS) has been shown to reduce post–endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) in both average- and high-risk patients (NEJM JW Gastroenterol Nov 9 2016; [e-pub] and Clin Gastroenterol Hepatol 2016 Jun 14; [e-pub]). In the current randomized, placebo-controlled trial from a U.S. tertiary care center, researchers evaluated the efficacy of rectal indomethacin (RIND) suppositories with or without a bolus of LRS in preventing PEP in 192 high-risk patients. ERCPs were performed by two experienced therapeutic endoscopists working with an advanced therapeutic gastrointestinal fellow.

Patients were randomized to receive intravenous LRS (1 L) plus RIND sup…

Reviewing Author

David A. Johnson, MD

Disclosures

Consultant/Advisory boardMedscape/WebMD; Pfizer; CRH Medical Corporation; Aries

EquityCRH Medical Corporation

Editorial boardsMedscape Gastroenterology

Leadership positions in professional societiesAmerican College of Gastroenterology Research Institute Board of Directors