Rectal indomethacin reduces pancreatitis after ERCP

In a recent study, researchers found that rectal indomethacin significantly reduced the incidence of pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP) in high-risk patients.

The study, published in the April 12 edition of The New England Journal of Medicine, was led by B. Joseph Elmunzer, MD, with the Divison of Gastroenterology at the University of Michigan Medical Center.

In the multicenter, randomized, placebo-controlled, double-blind clinical trial, researchers assigned patients at elevated risk for post-ERCP to receive a single dose of rectal indomethacin or placebo immediately after ERCP. More than 600 patients were enrolled and 82% had a clinical suspicion of sphincter of Oddi dysfunction.

Post-ERCP pancreatitis developed in 9.2% of patients in the indomethacin group and in 16.9% in the placebo group. Moderate-to-severe pancreatitis developed in 4.4% in the indomethacin group and in 8.8% in the placebo group.

“Among patients at high risk for post-ERCP pancreatitis, rectal indomethacin significantly reduced the incidence of the condition,” the researchers wrote.

The study was funded by the National Institutes of Health.