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گوارش، جلد ۲۷، شماره ۴، صفحات ۲۲۸-۲۳۴
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عنوان انگلیسی Administration of Rectal Diclofenac before, Compared with before-after Endoscopic Retrograde Cholangiopancreatography to Prevent Pancreatitis; a Double-Blind Randomized Controlled Trial
چکیده انگلیسی مقاله Background: Acute pancreatitis is one of the most common complications following endoscopic retrograde cholangiopancreatography (ERCP), which can be life-threatening if the treatment is postponed. This study aimed to evaluate the effect of non-steroidal anti-inflammatory drugs (suppository diclofenac) on preventing post-ERCP pancreatitis (PEP). Materials and Methods: In this double-blind, randomized clinical trial, 219 patients referred to our ERCP unit who passed inclusion and exclusion criteria were randomly assigned to two groups: group A (103 patients) received a diclofenac suppository 30 minutes before and immediately after ERCP. In Group B (116 patients), a diclofenac suppository was prescribed only before the procedure. Patients were evaluated regarding clinical signs and symptoms of pancreatitis for 24 hours. Also, serum amylase level was checked at baseline, 6, and 24 hours after the procedure. The study protocol was approved by the Ethics Committee of the Iran University of Medical Sciences (IR.IUMS.FMD.REC.1399.190). Also, the study protocol was registered in the Iranian Registry for Clinical Trials (IRCT20191231045969N2). Results: The PEP was seen in three patients in group A and seven patients in group B, which was not significantly different (P=0.341). The severity of pancreatitis was mild in all patients except one in group B, who developed moderate PEP. Moreover, in 97.71 % of cases, ERCP was successful for the first time, and in 94.18 % of group A and 89.66% of group B, no complications of bleeding or perforation were detected. Conclusion: Administration of rectal diclofenac before and after ERCP had no significant effect on the prevention of pancreatitis compared with pre-ERCP administration.
کلیدواژه‌های انگلیسی مقاله Pancreatitis,Diclofenac,NSAIDs,Endoscopic retrograde cholangiopancreatography,Randomized controlled trial
نویسندگان مقاله | Mahsa Agahi
Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran


| Farhad Zamani
Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran


| Homa Abri
Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran


| Amirhossein Faraji
Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran


| Mahmoodreza Khoonsari
Department of Pathology, Imam Khomeini Hospital Complex, Tehran, Iran


| Fatemeh Fargang
Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran


| Elham Sobh Rakhshankhah
Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran


| Hossein Ajdarkosh
Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Community and Family Medicine Department, School of Medicine, Iran University of Medical Sciences, Tehran, Iran


| Maryam Biglari Abhari
Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran


| Masoudreza Sohrabi
Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran


| Fahimeh Safarnezhad Tameshkel2
Department of Internal Medicine (Gastrointestinal Division), Ardabil University of Medical Sciences, Ardabil, Iran


| Alireza Shaygannejad
Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran


| Mehdi Nikkhah


نشانی اینترنتی http://govaresh.org/index.php/dd/article/view/2524
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