Can a single dose corticosteroid reduce the incidence of post-ERCP pancreatitis? A randomized, prospective control study.

BACKGROUND

Acute pancreatitis is one of the complications after Endoscopic retrograde cholangio pancreatography (ERCP) and it could be fatal. Several drugs were used to prevent or decrease this complication. Corticosteroid is one of the medications which may have such potential. It is affordable and available everywhere.

OBJECTIVES

To compare the incidence of post-ERCP pancreatitis in patients receiving single dose corticosteroid prior to the procedure with that of the control group .

RESEARCH DESIGN

A prospective randomized controlled double-blinded study.

MATERIAL AND METHOD

A total of 120 patients were randomized to receive either intravenous hydrocortisone 100 mg. or normal saline 1 hour prior to the procedure. The serum amylase levels were recorded 4 and 24 hours after the procedure. Abdominal pain and back pain were also recorded. Patients were diagnosed as having post-ERCP pancreatitis if ones had new or worsened epigastric pain with or without radiation to the back combined with elevation of serum amylase more than 2.5 times the upper limit.

RESULTS

The overall incidence of pancreatitis was 6.67% with 1.64% in the study group compared with 11.86% in the control group (p = 0.031). The groups were similar with regard to age, gender, type of procedure performed (diagnostic or therapeutic), difficulty of cannulation, concentration of contrast media and pre operative amylase level.

CONCLUSION

The results of the present trial indicate that hydrocortisone could reduce the risk of post-ERCP pancreatitis.