PROPHYLAXIS EFFECT OF NAPROXEN AND INDOMETHACINE IN POST ENDOSCOPIC PANCREATITIS: RANDOMIZED CONTROLLED TRIAL
Keywords:
Naproxen, Indomethacine, NSAIDs, ERCP, pancreatitis.Abstract
Endoscopic retrograde cholangiopancreatography ERCP can be accompanied with complications like post-ERCP pancreatitis (PEP). In this study we aimed to examine and compare the effects of 500 mg naproxen and 100 mg indomethacin as a single dose rectal administration in prevention of PEP in patients after diagnostic or therapeutic ERCP.
This double-blind randomized prospective monocentric clinical study was implemented during the period of January-April 2022 in 60 patients referred for ERCP at the University Clinical Centre of Kosovo – Prishtina. Patients were divided into two groups with 30 patients each. Before the ERCP, group A received 500 mg naproxen and group B received 100 mg indomethacin.
The incidence of PEP was 15% (9/60), 16.67% vs. 13.33% in groups A and B, respectively (p=0.5000). No significant differences were found between patients with PEP in groups A/B related to age (p=0.8065), BMI (p=0.8064) and ERCP duration (p=0.6242). The comparison of amylases, lipase and CRP in patients with PEP from group A/group B (before, 4h and 24h after ERCP) showed no significant differences.
Prophylactic naproxen or indomethacin had no significant difference in prophylaxis of PEP after ERCP. Differences between PEP cases from the two groups regarding selected parameters were not significant. Taking into account the relatively small sample of patients with PEP in our study, we are aware of the need for more extensive research in this field in the Republic of Kosovo for defining an effective way in reduction of PEP after ERCP.
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