Kotha Rudrani, Saad-Omer Sabaa I, Singh Shivani, Olayinka Oluwatoba T, Orelus Jaslin, Nisar Mah Rukh, Nassar Sondos T
Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.
Neurology/Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.
Cureus. 2024 Aug 7;16(8):e66386. doi: 10.7759/cureus.66386. eCollection 2024 Aug.
Endoscopic cholangiopancreatography (ERCP) is a widely used diagnostic and therapeutic tool for pancreaticobiliary conditions. One of its major complications is pancreatitis. This study aims to understand the incidence of post-ERCP pancreatitis after using rectal diclofenac and Indomethacin as prophylactic measures. We retrieved 2870 articles from the PubMed, ScienceDirect, and Google Scholar databases. Using the Medical Subject Headings (MeSH) strategy in PubMed, we chose research articles published in the last five years. Exclusion criteria included paid full-text articles, abstracts, letters to editors, patients not undergoing ERCP, ages more than 45 years, animal studies, and non-English studies. The 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) criteria were used in the design of our systematic reviews. It was found that the medical world is still debating whether rectal diclofenac and Indomethacin are beneficial in avoiding post-ERCP pancreatitis (PEP). Rectal diclofenac is used. Although its effectiveness is debated due to mixed findings and concerns about certain outcomes, it is also considered beneficial in specific circumstances, such as before ERCP. Studies on rectal Indomethacin also yield contradictory results; while some emphasize the drug's large reduction in PEP incidence, especially in low-risk people, others question its efficacy. We need further studies to clarify the remaining uncertainties.
内镜逆行胰胆管造影术（ERCP）是一种广泛应用于胰胆管疾病的诊断和治疗工具。其主要并发症之一是胰腺炎。本研究旨在了解使用直肠双氯芬酸和吲哚美辛作为预防措施后ERCP术后胰腺炎的发生率。我们从PubMed、ScienceDirect和谷歌学术数据库中检索了2870篇文章。使用PubMed中的医学主题词（MeSH）策略，我们选择了过去五年发表的研究文章。排除标准包括付费全文文章、摘要、给编辑的信件、未接受ERCP的患者、年龄超过45岁、动物研究和非英语研究。我们在系统评价的设计中使用了2020年系统评价和荟萃分析的首选报告项目（PRISMA）标准。结果发现，医学界仍在争论直肠双氯芬酸和吲哚美辛是否有利于避免ERCP术后胰腺炎（PEP）。直肠双氯芬酸被使用。尽管由于结果不一和对某些结果的担忧，其有效性存在争议，但在特定情况下，如ERCP术前，它也被认为是有益的。关于直肠吲哚美辛的研究也产生了相互矛盾的结果；一些研究强调该药物可大幅降低PEP发生率，尤其是在低风险人群中，而另一些研究则质疑其疗效。我们需要进一步的研究来澄清其余的不确定性。
