From the Third Department of Internal Medicine, Kansai Medical University.
Kansai Medical University Kori Hospital, Osaka, Japan.
Pancreas. 2021 Aug 1;50(7):1024-1029. doi: 10.1097/MPA.0000000000001877.
We evaluated the preventive effect of low-dose diclofenac (25-50 mg) on post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) by propensity score matching analysis.
We retrospectively analyzed the data of 515 patients who underwent ERCP for the first time with or without the rectal administration of low-dose diclofenac before the procedure. For the purpose of minimization of the intrinsic selection bias, we compared the incidence rate of PEP between the diclofenac and control group after propensity score matching.
Post-ERCP pancreatitis developed in 15 patients (2.9%). There was no significant difference in the incidence of PEP between the diclofenac (2.4%) and control group (3.3%) (P = 0.608). One hundred ninety matched pairs were generated by propensity score matching and analyzed; however, the incidence rate of PEP was the same in both groups (2.1%, P = 1.000). In the subgroup analysis using data of patients with high-risk factors for developing PEP, the incidence rate of PEP was comparable between the diclofenac (3.8%) and control groups (4.0%) (P = 0.917).
In our propensity score analysis, rectal administration of low-dose diclofenac was not shown to be useful in preventing PEP.
通过倾向评分匹配分析评估低剂量双氯芬酸（25-50mg）对内镜逆行胰胆管造影（ERCP）后胰腺炎（PEP）的预防作用。
我们回顾性分析了 515 例首次接受 ERCP 治疗的患者的数据，这些患者在接受 ERCP 前直肠给予或未给予低剂量双氯芬酸。为了最小化内在选择偏差，我们在倾向评分匹配后比较了双氯芬酸组和对照组的 PEP 发生率。
15 例（2.9%）发生 ERCP 后胰腺炎。双氯芬酸组（2.4%）和对照组（3.3%）的 PEP 发生率无显著差异（P=0.608）。通过倾向评分匹配生成了 190 对匹配对进行分析，但两组的 PEP 发生率相同（2.1%，P=1.000）。在对有发生 PEP 高风险因素的患者进行亚组分析时，双氯芬酸组（3.8%）和对照组（4.0%）的 PEP 发生率无差异（P=0.917）。
在我们的倾向评分分析中，直肠给予低剂量双氯芬酸似乎不能预防 PEP。
