IMPACT OF RECTAL DICLOFENAC IN PREVENTING POST ENDOSCOPIC RETROGRADE CHOLANGIO PANCREATOGRAPHY PANCREATITIS: A RANDOMIZED PROSPECTIVE STUDY
Binish Hassan, *Tehreem Fatima, Sajjad Hussain Chandio, Muhammad Owais, Hassan Mumtaz, Ayesha Fatima and Fatima Meer
ABSTRACT
Introduction: There is a conflict regarding the efficacy of diclofenac in reducing the frequency of post ERCP pancreatitis. There was a need to conduct this study in the local population so that this conflict could be resolved which can help us in opting diclofenac in regular use among the patients undergoing ERCP to prevent pancreatitis associated with it. The aim of our study was to compare the frequency of pancreatitis in post endoscopic retrograde cholangiopancreatography patients treated with and without diclofenac suppositories. Methods: A total of ninety (n=90) patients of either gender between age 20-70 years who presented with radiologically proven stones in CBD were enrolled. Patients were randomly divided into 2 groups. Group A was administered per rectal 100 mg of diclofenac potassium and Group B was taken as a control group. All the patients underwent ERCP and were monitored for 48 hours for the diagnosis of post ERCP pancreatitis (PEP). Results: PEP was diagnosed in 17.8% (n=8/45) in group A patients while it was diagnosed in 44.4% (n=20/45) patients in group B (p=0.006). The efficacy of diclofenac potassium was significantly better among males with shorter duration of the procedure (P<0.05). No other statistical difference noted (P>0.05 in the rest of the cases). Conclusions: Efficacy of per rectal diclofenac potassium for prophylaxis of post-ERCP pancreatitis was significantly better when compared with the control group.
Keywords: ERCP, Pancreatitis, PR Diclofenac, Nsaids.
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