Evaluation of pancreatic stent and/or suppository indomethacin efficacy in post ERCP pancreatitis prophylaxis: a single center experience

Çağdaş Erdoğan; İbrahim Ethem Güven; Batuhan Başpınar; Zeki Mesut Yalın Kılıç

doi:10.32322/jhsm.1197804

Research Article

Year 2023, Volume: 6 Issue: 2, 374 - 379, 27.03.2023

Çağdaş Erdoğan İbrahim Ethem Güven Batuhan Başpınar Zeki Mesut Yalın Kılıç

https://doi.org/10.32322/jhsm.1197804

Abstract

References

1. Peery AF, Crockett SD, Barritt AS, et al. Burden of Gastrointestinal, Liver, and Pancreatic Diseases in the United States. Gastroenterology 2015; 149:1731.
2. TORVIK A, HOIVIK B. Gallstones in an autopsy series. Incidence, complications, and correlations with carcinoma of the gallbladder. Acta Chir Scand 1960; 120:168.
3. Zahor A, Sternby NH, Kagan A, et al. Frequency of cholelithiasis in Prague and Malmö. An autopsy study. Scand J Gastroenterol 1974; 9:3.
4. Brett M, Barker DJ. The world distribution of gallstones. Int J Epidemiol 1976; 5:335.
5. Collins C, Maguire D, Ireland A, et al. A prospective study of common bile duct calculi in patients undergoing laparoscopic cholecystectomy: natural history of choledocholithiasis revisited. Ann Surg 2004; 239:28.
6. Hunter JG. Laparoscopic transcystic common bile duct exploration. Am J Surg 1992; 163:53.
7. Prat F, Amouyal G, Amouyal P, et al. Prospective controlled study of endoscopic ultrasonography and endoscopic retrograde cholangiography in patients with suspected common-bileduct lithiasis. Lancet 1996; 347:75.
8. Gurusamy KS, Giljaca V, Takwoingi Y, et al. Endoscopic retrograde cholangiopancreatography versus intraoperative cholangiography for diagnosis of common bile duct stones. Cochrane Database Syst Rev 2015; :CD010339.
9. Siiki A, Tamminen A, Tomminen T, Kuusanmäki P. ERCP procedures in a Finnish community hospital: a retrospective analysis of 1207 cases. Scand J Surg 2012; 101:45.
10. Kapral C, Mühlberger A, Wewalka F, et al. Quality assessment of endoscopic retrograde cholangiopancreatography: results of a running nationwide Austrian benchmarking project after 5 years of implementation. Eur J Gastroenterol Hepatol 2012; 24:1447.
11. Kienbauer M, Duller C, Gschwantler M, et al. [Austrian benchmarking project for ERCP: a 10-year report]. Z Gastroenterol 2018; 56:1227.
12. Glomsaker T, Hoff G, Kvaløy JT, et al. Patterns and predictive factors of complications after endoscopic retrograde cholangiopancreatography. Br J Surg 2013; 100:373.
13. Andriulli A, Loperfido S, Napolitano G, et al. Incidence rates of post-ERCP complications: a systematic survey of prospective studies. Am J Gastroenterol 2007; 102:1781.
14. Dumonceau JM, Kapral C, Aabakken L, et al. ERCP-related adverse events: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy 2020; 52:127.
15. Kochar B, Akshintala VS, Afghani E, et al. Incidence, severity, and mortality of post-ERCP pancreatitis: a systematic review by using randomized, controlled trials. Gastrointest Endosc 2015; 81:143.
16. Morales SJ, Sampath K, Gardner TB. A Review of Prevention of Post-ERCP Pancreatitis. Gastroenterol Hepatol (N Y) 2018; 14:286.
17. ASGE Standards of Practice Committee, Chandrasekhara V, Khashab MA, et al. Adverse events associated with ERCP. Gastrointest Endosc 2017; 85:32.
18. Phillip, V., Pukitis, A., Epstein, A., Hapfelmeier, A., Haf, D., Schwab, M., Demir, I. E., Rosendahl, J., Hoffmeister, A., Schmid, R. M., Weber, A., & Algül, H. (2019). Pancreatic stenting to prevent post-ERCP pancreatitis: a randomized multicenter trial. Endoscopy international open, 7(7), E860–E868. https://doi.org/10.1055/a-0886-6384
19. Pekgöz M. Post-endoscopic retrograde cholangiopancreatography pancreatitis: A systematic review for prevention and treatment. World J Gastroenterol. 2019;25(29):4019-4042. doi:10.3748/wjg.v25.i29.4019
20. Masci, E., Mariani, A., Curioni, S., & Testoni, P. A. (2003). Risk factors for pancreatitis following endoscopic retrograde cholangiopancreatography: a meta-analysis. Endoscopy, 35(10), 830–834. https://doi.org/10.1055/s-2003-42614
21. Harewood, G. C., Pochron, N. L., & Gostout, C. J. (2005). Prospective, randomized, controlled trial of prophylactic pancreatic stent placement for endoscopic snare excision of the duodenal ampulla. Gastrointestinal endoscopy, 62(3), 367–370. https://doi.org/10.1016/j.gie.2005.04.020
22. Döbrönte, Z., Toldy, E., Márk, L., Sarang, K., & Lakner, L. (2012). Az indometacin szerepe az endoszkópos retrográd cholangiopancreatographiát követő akut pancreatitis prevenciójában [Effects of rectal indomethacin in the prevention of post-ERCP acute pancreatitis]. Orvosi hetilap, 153(25), 990–996. https://doi.org/10.1556/OH.2012.29403
23. Elmunzer, B. J., Scheiman, J. M., Lehman, G. A., Chak, A., Mosler, P., Higgins, P. D., Hayward, R. A., Romagnuolo, J., Elta, G. H., Sherman, S., Waljee, A. K., Repaka, A., Atkinson, M. R., Cote, G. A., Kwon, R. S., McHenry, L., Piraka, C. R., Wamsteker, E. J., Watkins, J. L., Korsnes, S. J., … U.S. Cooperative for Outcomes Research in Endoscopy (USCORE) (2012). A randomized trial of rectal indomethacin to prevent post-ERCP pancreatitis. The New England journal of medicine, 366(15), 1414–1422. https://doi.org/10.1056/NEJMoa1111103
24. Yaghoobi, M., Rolland, S., Waschke, K. A., McNabb-Baltar, J., Martel, M., Bijarchi, R., Szego, P., & Barkun, A. N. (2013). Meta-analysis: rectal indomethacin for the prevention of post-ERCP pancreatitis. Alimentary pharmacology & therapeutics, 38(9), 995–1001. https://doi.org/10.1111/apt.12488

Evaluation of pancreatic stent and/or suppository indomethacin efficacy in post ERCP pancreatitis prophylaxis: a single center experience

Year 2023, Volume: 6 Issue: 2, 374 - 379, 27.03.2023

Çağdaş Erdoğan İbrahim Ethem Güven Batuhan Başpınar Zeki Mesut Yalın Kılıç

https://doi.org/10.32322/jhsm.1197804

Abstract

Aim: Post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) is a serious complication of ERCP. In this study, we aimed to compare the use of rectal indomethacin, pancreatic stenting or both techniques for prevention of PEP.
Material and Method: Patients who underwent ERCP for the first time due to choledocholithiasis between January 2022 and June 2022 were retrospectively reviewed. The clinical findings, demographics, laboratory records, endoscopic intervention characteristics, whether rectal indomethacin was applied before the procedure, whether pancreatic stent was placed or not were evaluated.
Results: A total of 367 patients who underwent ERCP for the first time were included in the study. The mean age was 61 (28-92) years and 53.4% were female. In 124 (33.8%) patients, involuntary guide-wire insertion into the pancreatic duct occurred during canulation. Pancreatic stent was placed in 82 (22.3%) of the patients. Rectal indomethacin was administered to 288 patients (78.5%), while indomethacin could not be administered in 79 patients (21.5%), because they did not give consent. When patients with involuntarily pancreatic canulation were evaluated, the rate of PEP was 3.6% in the stented group, while it was 15.3% in the stent-free group (p<0001). The incidence of PEP was 20.3% in 79 patients who could not be administered rectal indomethacin, while this rate was 3.1% in those who received rectal indomethacin (p<0001).
Conclusion: The first and most important way to prevent PEP is to avoid unnecessary ERCPs. Rectal indomethacin administration reduces the risk of PEP. All patients with involuntary wires in the pancreatic duct, should be evaluated for pancreatic stent placement.

Keywords

Post-ERCP pancreatitis, rectal indomethacin, pancreatic stent, prophlaxis

References

1. Peery AF, Crockett SD, Barritt AS, et al. Burden of Gastrointestinal, Liver, and Pancreatic Diseases in the United States. Gastroenterology 2015; 149:1731.
2. TORVIK A, HOIVIK B. Gallstones in an autopsy series. Incidence, complications, and correlations with carcinoma of the gallbladder. Acta Chir Scand 1960; 120:168.
3. Zahor A, Sternby NH, Kagan A, et al. Frequency of cholelithiasis in Prague and Malmö. An autopsy study. Scand J Gastroenterol 1974; 9:3.
4. Brett M, Barker DJ. The world distribution of gallstones. Int J Epidemiol 1976; 5:335.
5. Collins C, Maguire D, Ireland A, et al. A prospective study of common bile duct calculi in patients undergoing laparoscopic cholecystectomy: natural history of choledocholithiasis revisited. Ann Surg 2004; 239:28.
6. Hunter JG. Laparoscopic transcystic common bile duct exploration. Am J Surg 1992; 163:53.
7. Prat F, Amouyal G, Amouyal P, et al. Prospective controlled study of endoscopic ultrasonography and endoscopic retrograde cholangiography in patients with suspected common-bileduct lithiasis. Lancet 1996; 347:75.
8. Gurusamy KS, Giljaca V, Takwoingi Y, et al. Endoscopic retrograde cholangiopancreatography versus intraoperative cholangiography for diagnosis of common bile duct stones. Cochrane Database Syst Rev 2015; :CD010339.
9. Siiki A, Tamminen A, Tomminen T, Kuusanmäki P. ERCP procedures in a Finnish community hospital: a retrospective analysis of 1207 cases. Scand J Surg 2012; 101:45.
10. Kapral C, Mühlberger A, Wewalka F, et al. Quality assessment of endoscopic retrograde cholangiopancreatography: results of a running nationwide Austrian benchmarking project after 5 years of implementation. Eur J Gastroenterol Hepatol 2012; 24:1447.
11. Kienbauer M, Duller C, Gschwantler M, et al. [Austrian benchmarking project for ERCP: a 10-year report]. Z Gastroenterol 2018; 56:1227.
12. Glomsaker T, Hoff G, Kvaløy JT, et al. Patterns and predictive factors of complications after endoscopic retrograde cholangiopancreatography. Br J Surg 2013; 100:373.
13. Andriulli A, Loperfido S, Napolitano G, et al. Incidence rates of post-ERCP complications: a systematic survey of prospective studies. Am J Gastroenterol 2007; 102:1781.
14. Dumonceau JM, Kapral C, Aabakken L, et al. ERCP-related adverse events: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy 2020; 52:127.
15. Kochar B, Akshintala VS, Afghani E, et al. Incidence, severity, and mortality of post-ERCP pancreatitis: a systematic review by using randomized, controlled trials. Gastrointest Endosc 2015; 81:143.
16. Morales SJ, Sampath K, Gardner TB. A Review of Prevention of Post-ERCP Pancreatitis. Gastroenterol Hepatol (N Y) 2018; 14:286.
17. ASGE Standards of Practice Committee, Chandrasekhara V, Khashab MA, et al. Adverse events associated with ERCP. Gastrointest Endosc 2017; 85:32.
18. Phillip, V., Pukitis, A., Epstein, A., Hapfelmeier, A., Haf, D., Schwab, M., Demir, I. E., Rosendahl, J., Hoffmeister, A., Schmid, R. M., Weber, A., & Algül, H. (2019). Pancreatic stenting to prevent post-ERCP pancreatitis: a randomized multicenter trial. Endoscopy international open, 7(7), E860–E868. https://doi.org/10.1055/a-0886-6384
19. Pekgöz M. Post-endoscopic retrograde cholangiopancreatography pancreatitis: A systematic review for prevention and treatment. World J Gastroenterol. 2019;25(29):4019-4042. doi:10.3748/wjg.v25.i29.4019
20. Masci, E., Mariani, A., Curioni, S., & Testoni, P. A. (2003). Risk factors for pancreatitis following endoscopic retrograde cholangiopancreatography: a meta-analysis. Endoscopy, 35(10), 830–834. https://doi.org/10.1055/s-2003-42614
21. Harewood, G. C., Pochron, N. L., & Gostout, C. J. (2005). Prospective, randomized, controlled trial of prophylactic pancreatic stent placement for endoscopic snare excision of the duodenal ampulla. Gastrointestinal endoscopy, 62(3), 367–370. https://doi.org/10.1016/j.gie.2005.04.020
22. Döbrönte, Z., Toldy, E., Márk, L., Sarang, K., & Lakner, L. (2012). Az indometacin szerepe az endoszkópos retrográd cholangiopancreatographiát követő akut pancreatitis prevenciójában [Effects of rectal indomethacin in the prevention of post-ERCP acute pancreatitis]. Orvosi hetilap, 153(25), 990–996. https://doi.org/10.1556/OH.2012.29403
23. Elmunzer, B. J., Scheiman, J. M., Lehman, G. A., Chak, A., Mosler, P., Higgins, P. D., Hayward, R. A., Romagnuolo, J., Elta, G. H., Sherman, S., Waljee, A. K., Repaka, A., Atkinson, M. R., Cote, G. A., Kwon, R. S., McHenry, L., Piraka, C. R., Wamsteker, E. J., Watkins, J. L., Korsnes, S. J., … U.S. Cooperative for Outcomes Research in Endoscopy (USCORE) (2012). A randomized trial of rectal indomethacin to prevent post-ERCP pancreatitis. The New England journal of medicine, 366(15), 1414–1422. https://doi.org/10.1056/NEJMoa1111103
24. Yaghoobi, M., Rolland, S., Waschke, K. A., McNabb-Baltar, J., Martel, M., Bijarchi, R., Szego, P., & Barkun, A. N. (2013). Meta-analysis: rectal indomethacin for the prevention of post-ERCP pancreatitis. Alimentary pharmacology & therapeutics, 38(9), 995–1001. https://doi.org/10.1111/apt.12488

There are 24 citations in total.

Details

Primary Language	English
Subjects	Health Care Administration
Journal Section	Original Article
Authors	Çağdaş Erdoğan 0000-0001-5903-6559 İbrahim Ethem Güven 0000-0002-7436-6414 Batuhan Başpınar 0000-0003-3143-2642 Zeki Mesut Yalın Kılıç 0000-0003-2307-905X
Publication Date	March 27, 2023
Published in Issue	Year 2023 Volume: 6 Issue: 2

Cite

AMA	Erdoğan Ç, Güven İE, Başpınar B, Kılıç ZMY. Evaluation of pancreatic stent and/or suppository indomethacin efficacy in post ERCP pancreatitis prophylaxis: a single center experience. J Health Sci Med / JHSM. March 2023;6(2):374-379. doi:10.32322/jhsm.1197804

Download Cover Image

Article Files

Full Text

Interuniversity Board (UAK) Equivalency: Article published in Ulakbim TR Index journal [10 POINTS], and Article published in other (excuding 1a, b, c) international indexed journal (1d) [5 POINTS].

The Directories (indexes) and Platforms we are included in are at the bottom of the page.

Note: Our journal is not WOS indexed and therefore is not classified as Q.

You can download Council of Higher Education (CoHG) [Yüksek Öğretim Kurumu (YÖK)] Criteria) decisions about predatory/questionable journals and the author's clarification text and journal charge policy from your browser. https://dergipark.org.tr/tr/journal/2316/file/4905/show

The indexes of the journal are ULAKBİM TR Dizin, Index Copernicus, ICI World of Journals, DOAJ, Directory of Research Journals Indexing (DRJI), General Impact Factor, ASOS Index, WorldCat (OCLC), MIAR, EuroPub, OpenAIRE, Türkiye Citation Index, Türk Medline Index, InfoBase Index, Scilit, etc.

The platforms of the journal are Google Scholar, CrossRef (DOI), ResearchBib, Open Access, COPE, ICMJE, NCBI, ORCID, Creative Commons, etc.

Our Journal using the DergiPark system indexed are;

Ulakbim TR Dizin, Index Copernicus, ICI World of Journals, Directory of Research Journals Indexing (DRJI), General Impact Factor, ASOS Index, OpenAIRE, MIAR, EuroPub, WorldCat (OCLC), DOAJ, Türkiye Citation Index, Türk Medline Index, InfoBase Index

Our Journal using the DergiPark system platforms are;

Google, Google Scholar, CrossRef (DOI), ResearchBib, ICJME, COPE, NCBI, ORCID, Creative Commons, Open Access, and etc.

Journal articles are evaluated as "Double-Blind Peer Review".

Our journal has adopted the Open Access Policy and articles in JHSM are Open Access and fully comply with Open Access instructions. All articles in the system can be accessed and read without a journal user. https//dergipark.org.tr/tr/pub/jhsm/page/9535

Journal charge policy https://dergipark.org.tr/tr/pub/jhsm/page/10912

Editor List for 2022

Assoc. Prof. Alpaslan TANOĞLU (MD)

Prof. Aydın ÇİFCİ (MD)

Prof. İbrahim Celalaettin HAZNEDAROĞLU (MD)

Prof. Murat KEKİLLİ (MD)

Prof. Yavuz BEYAZIT (MD)

Prof. Ekrem ÜNAL (MD)

Prof. Ahmet EKEN (MD)

Assoc. Prof. Ercan YUVANÇ (MD)

Assoc. Prof. Bekir UÇAN (MD)

Assoc. Prof. Mehmet Sinan DAL (MD)

Our journal has been indexed in DOAJ as of May 18, 2020.

Our journal has been indexed in TR-Dizin as of March 12, 2021.

Articles published in the Journal of Health Sciences and Medicine have open access and are licensed under the Creative Commons CC BY-NC-ND 4.0 International License.