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Intramuscular diclofenac for the prevention of post-ERCP pancreatitis: a randomized trial

Authors
 Se Woo Park  ;  Moon Jae Chung  ;  Tak Geun Oh  ;  Jeong Youp Park  ;  Seungmin Bang  ;  Seung Woo Park  ;  Si Young Song 
Citation
 ENDOSCOPY, Vol.47(1) : 33-39, 2015 
Journal Title
 ENDOSCOPY 
ISSN
 0013-726X 
Issue Date
2015
MeSH
Adult ; Aged ; Anti-Inflammatory Agents, Non-Steroidal/administration & dosage* ; Anti-Inflammatory Agents, Non-Steroidal/therapeutic use ; Cholangiopancreatography, Endoscopic Retrograde/adverse effects* ; Diclofenac/administration & dosage* ; Diclofenac/therapeutic use ; Double-Blind Method ; Drug Administration Schedule ; Female ; Humans ; Incidence ; Injections, Intramuscular ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Pancreatitis/epidemiology ; Pancreatitis/etiology ; Pancreatitis/prevention & control* ; Risk Factors ; Severity of Illness Index ; Treatment Outcome
Abstract
BACKGROUND AND STUDY AIMS: Rectal nonsteroidal anti-inflammatory drugs have been shown to reduce the incidence of postendoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP). The aim of this study was to determine whether intramuscular diclofenac reduces the risk of PEP. PATIENTS AND METHODS: Patients who underwent ERCP were randomized to receive either 90 mg of diclofenac or placebo by intramuscular injection immediately after the procedure. PEP was defined as elevated serum amylase levels (at least three times the upper limit of normal 24 hours after the procedure) associated with new or worsened upper abdominal, epigastric, or back pain. RESULTS: In total, 380 patients were randomized, and 343 were eligible for analysis. The two groups were similar regarding clinical and demographic factors, as well as patient- and procedure-related risk factors for PEP. PEP developed in 20/170 patients (11.8 %) in the placebo group and in 22/173 patients (12.7 %) in the diclofenac group (P = 0.87). Multivariate regression analysis failed to illustrate that intramuscular diclofenac prevented PEP (odds ratio 0.79; 95 % confidence interval 0.39 - 1.25; P = 0.51). CONCLUSION: Prophylactic intramuscular diclofenac had no beneficial preventive effect on PEP.
Full Text
https://www.thieme-connect.com/DOI/DOI?10.1055/s-0034-1390743
DOI
10.1055/s-0034-1390743
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Park, Seung Woo(박승우) ORCID logo https://orcid.org/0000-0001-8230-964X
Park, Jeong Youp(박정엽) ORCID logo https://orcid.org/0000-0003-0110-8606
Bang, Seungmin(방승민) ORCID logo https://orcid.org/0000-0001-5209-8351
Song, Si Young(송시영) ORCID logo https://orcid.org/0000-0002-1417-4314
Oh, Tak Geun(오탁근)
Chung, Moon Jae(정문재) ORCID logo https://orcid.org/0000-0002-5920-8549
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/139435
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