Leerhøy Bonna, Nordholm-Carstensen Andreas, Novovic Srdan, Hansen Mark Berner, Jørgensen Lars Nannestad
From the *Digestive Disease Center, Bispebjerg Hospital, University of Copenhagen, Copenhagen; †Department of Gastroenterology and Surgical Gastroenterology, Hvidovre Hospital, University Hospital Hvidovre, Hvidovre, Denmark; and ‡AstraZeneca Research and Development, Mölndal, Sweden.
Pancreas. 2014 Nov;43(8):1286-90. doi: 10.1097/MPA.0000000000000169.
The aim of this study was to assess the clinical effect of diclofenac administered as a single dose for the prevention of postprocedure pancreatitis in a consecutive series of patients who had undergone endoscopic retrograde cholangiopancreatography (ERCP).
Patients with a native papilla Vateri subjected to ERCP during 2010 (control group, n = 218) and 2012 (diclofenac group, n = 182) were included. Patients with a history of chronic pancreatitis or recent acute pancreatitis were excluded. From January 2012, a rectal suppository containing 100 mg of diclofenac was administered immediately after endoscopy in all patients. The primary outcome of post-ERCP pancreatitis was assessed retrospectively by reviewing the patients' charts.
The overall incidence of post-ERCP pancreatitis was 32 (14.7%) of the 218 patients in the control group and 9 (4.9%) of the 182 patients in the diclofenac group (P = 0.002). Moderate to severe pancreatitis occurred in 22 (10.1%) of the 218 patients in the control group versus 8 (4.4%) of the 182 patients in the diclofenac group (P = 0.036).
This controlled cohort study suggests that the implementation of a single dose of 100 mg of diclofenac rectally administered significantly reduces the incidence of post-ERCP pancreatitis in an unselected material of patients with native papilla.
本研究旨在评估在一系列连续接受内镜逆行胰胆管造影（ERCP）的患者中，单次服用双氯芬酸预防术后胰腺炎的临床效果。
纳入2010年（对照组，n = 218）和2012年（双氯芬酸组，n = 182）接受ERCP检查的具有天然十二指肠乳头的患者。排除有慢性胰腺炎病史或近期急性胰腺炎病史的患者。从2012年1月起，所有患者在内镜检查后立即给予含100 mg双氯芬酸的直肠栓剂。通过查阅患者病历回顾性评估ERCP术后胰腺炎的主要结局。
对照组218例患者中，ERCP术后胰腺炎的总发生率为32例（14.7%），双氯芬酸组182例患者中为9例（4.9%）（P = 0.002）。对照组218例患者中有22例（10.1%）发生中重度胰腺炎，双氯芬酸组182例患者中有8例（4.4%）发生中重度胰腺炎（P = 0.036）。
这项对照队列研究表明，在未选择的具有天然乳头的患者群体中，直肠给予单剂量100 mg双氯芬酸可显著降低ERCP术后胰腺炎的发生率。
