The incidence of post-ERCP pancreatitis is not reduced in patients given intravenous ketorolac for post-procedural abdominal pain
Journal Title: Journal of Hepatology and Gastroenterology - Year 2016, Vol 1, Issue 2
Abstract
Introduction: Nonsteroidal anti-inflammatory drugs (NSAIDs) (e.g. indomethacin), administered rectally, seem to be effective in reducing post-ERCP pancreatitis (PEP). This effect seems lost with intramuscularly or intravenously administration. Our aim is to assess whether intravenous ketorolac given as an analgesic to patients with post-procedural abdominal pain reduces the rate of PEP. Material and methods: We retrospectively evaluated all hospital in-patients who had undergone therapeutic ERCP in a one-year period, comparing the rates of PEP in those who developed post-ERCP abdominal pain and those who did not. Patients with pain received ketorolac as analgesic NSAID (group A), patients without pain did not (group B). Patients with post-ERCP abdominal pain who were given ketorolac were also compared with those treated with non-NSAIDs because of contraindications. Results and discussion: A total of 587 patients underwent ERCP: 277 had post-procedural abdominal pain (47%), 310 had none. Among patients with pain, the rates of PEP were 7.8% for those given ketorolac and 8.5% for those taking non-NSAIDs (p = 0.79). Comparing groups A and B, the rates of PEP were not significantly different considering both all the patients (respectively 7.8% and 4.2%, p = 0.08) and those at high risk (3.8% and 6%, p = 0.6). In multivariate analysis, only age was significantly associated with PEP (p = 0.03); ketorolac was not (p = 0.16). Conclusions: Intravenous ketorolac to patients with post-ERCP abdominal pain seemed not to reduce the rate of PEP in either the whole group or in patients at high risk for this complication, compared to patients with no post-ERCP pain and no treatment.
Authors and Affiliations
Mariani A, Grazie ML, Leo MD, Maini A, Testoni PA
Keywords
Related Articles
- EP ID EP555928
- DOI 10.14312/2399-8199.2016-2
- Views 40
- Downloads 0
Math, myth and the fundamentals of electrosurgery
An electrosurgery generator (ESU) is a critical piece of equipment found in every therapeutic endoscopic setting. The high frequency (RF or Radio Frequency) alternating currents produced by these ubiquitous generators pr...
Lumbosacral transcutaneous electrical stimulation in children with slow transit constipation: A pilot case series
Background and aim: This prospective pilot case series evaluated the efficacy of lumbosacral transcutaneous electrical stimulation using interferential current (TESIC) administered with a portable interferential device i...
Feedback inhibition of apolipoprotein A-I synthesis by its propeptide in hepatocyte cell culture and in the cell-free system
Addition of chemically synthesized proapolipoprotein A-I hexapeptides in a concentration of 10-4 mol/l in the medium of primary rat hepatocyte cell cultures decreased net apolipoprotein A-I synthesis by up to 13%. The in...
Combined treatment of refractory ascites by alfapumpTM and surgical umbilical hernia repair in cirrhotic patients: Is this the right paradigm?
Treatment of umbilical hernia in patients with refractory ascites due to cirrhosis is associated with a high risk of postoperative complications. Control of ascites must accompany and follow surgery in order to ensure ad...
A newly discovered controversial role of the neutralizing HCV antibodies in the relapse of hepatitis C virus
Despite all intensive efforts and widespread use of direct-acting antivirals (DAA), and their high sustained virological responses (SVR) rate and the clearance of hepatitis C virus (HCV) RNA from serum, the mechanism of...