Comparative Effectiveness Between Indomethacin and Pancreatic Stenting in the Prevention of Post ERCP Pancreatitis
Post ERCP Pancreatitis
About this trial
This is an interventional prevention trial for Post ERCP Pancreatitis focused on measuring post ERCP panceatitis, rectal indomethacin, pancreatic stents
Eligibility Criteria
Inclusion Criteria:
presence of one of the following risk factors for Post ERCP Pancreatitis
- sphincter of Oddi dysfunction
- history of PEP, pancreatic instrumentation or sphincterotomy, precut sphincterotomy,
- difficult cannulation defined by >5 cannulation attempts
- the use of double wire technique in bile duct access
- at least 2 of the followings including i) female age<50 ii) 3 pancreatograms iii) acinarization (contrast injection to tail fo pancreas). iv) normal bilirubin; v)guidewire to the tail of pancreas or secondary branches.
Exclusion Criteria:
- patients intended for pancreatic stenting e.g. those with pancreatic duct strictures, ampullectomy,
- without informed consents from patient or next of kin
- age <18
- pregnant or lactating women
- patients with altered anatomy except except Billroth I and II gastrectomy
- contraindications to the use of NSAIDs such as those with active gastrointestinal bleeding, renal failure (serum creatinine > 140)
- known NSAID allergy
- incipient heart failure.
Sites / Locations
- Endoscopy centreRecruiting
- Eastern Hepatobiliary Surgery Hospital,Endoscopy centreRecruiting
- Endoscopy centre
- Endoscopy centreRecruiting
- Endoscopy centreRecruiting
- Endoscopy Centre, Prince of Wales HospitalRecruiting
- 2. Chulalongkorn University and King Chulalongkorn Memorial HospitalRecruiting
Arms of the Study
Arm 1
Arm 2
Arm 3
Experimental
Experimental
Experimental
indomethacin
pancreatic stenting
indomethacin plus pancreatic stenting
rectal indomethacin 100 mg to be administered before or after ERCP
a PD stent to be inserted during ERCP (a 3 to 5 cm 5Fr single pigtail pancreatic duct stent without inner flap is used, the stent is inserted after deep cannulation of pancreatic duct with a .025" or .035" wire)
[rectal indomethacin 100 mg to be administered before or after ERCP] plus [a PD stent to be inserted during ERCP (a 3 to 5 cm 5Fr single pigtail pancreatic duct stent without inner flap is used, the stent is inserted after deep cannulation of pancreatic duct with a .025" or .035" wire]