Abstract

Introduction: Previous researches show that rectal indomethacin (RI) reduces the risk of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP). The aim of this study was to evaluate the utility of RI in preventing PEP.

Methods: We conceived a retrospective study including 89 patients who underwent ERCP at the Military Hospital Mohamed V of Rabat-Morocco over a period of 3 years (January 2019 to April 2022). We collected clinical features and procedures details from patients’ records.

Results: A total of 89 patients were included for this study. PEP occurred in 12 of 89 (13,5%) patients. In the univariate analysis, the factors were associated with PEP are: administration of RI, pancreatic cannulation, difficult cannulation, number of pancreatic duct cannulation and the contrast injection into the pancreatic duct. In the multivariate analysis, when adjusting with other PEP risk factors, administration of RI and difficult cannulation were significantly associated with a higher risk of PEP. RI reduced the risk of PEP by 88% (OR 0.12, 95%CI 0.02 - 0.84, p = 0.03) and difficult cannulation increase the risk of PEP (OR = 3.97, 95%CI 0.71 - 0.84, p = 0.03).

Conclusion: Prophylactic rectal indomethacin significantly reduced the rates of PEP and should be administrated for all patients undergoing ERCP.

Keywords: Endoscopic Retrograde Cholangio-Pancreatography (ERCP); Rectal Indomethacin (RI); Pancreatitis (PEP)

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