Prophylactic pancreatic stent with rectal indomethacin prevents post ERCP pancreatitis: Lancet
Pancreatitis is a known risk following ERCP and has long posed challenges for clinicians due to its complexity and potential harm. A recent study suggests a promising strategy to prevent pancreatitis in high-risk individuals who undergo endoscopic retrograde cholangiopancreatography (ERCP). The key findings were published in the recent edition of the The Lancet journal.
This comprehensive research was conducted across 20 referral centers in the USA and Canada and highlights a combination therapy that involved rectally administered indomethacin and prophylactic pancreatic stent placement. The findings of this study challenge the existing practices and offer a potentially safer and more effective alternative.
The randomized, non-inferiority trial included over 1950 patients who were aged 18 years and above and deemed to be at high risk for post-ERCP pancreatitis. The patients were randomly assigned to receive either rectal indomethacin alone or a combination of indomethacin and a pancreatic stent.
The results revealed that post-ERCP pancreatitis occurred in 14.9% of patients in the indomethacin alone group when compared to 11.3% in the combination therapy group. While the difference did not meet the predetermined criteria for non-inferiority, a subsequent analysis suggested that the combined approach was superior to indomethacin alone.
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