Rectal indomethacin to prevent pancreatitis after extracorporeal shock wave lithotripsy (RIPEP): A single-center, double-blind, randomized, placebo-controlled trial
The Lancet: Gastroenterology & Hepatology Feb 12, 2022
Findings demonstrate the efficacy as well as safety of preprocedural rectal indomethacin administration in decreasing the incidence of post-extracorporeal shock wave lithotripsy (ESWL) pancreatitis.
This double-blind, randomized, placebo-controlled trial included 1,370 patients aged 18 years or older with chronic pancreatitis and pancreatic stones (>5 mm in diameter) who were eligible for treatment with ESWL.
Participants were randomized to receive 100 mg rectal indomethacin or identical glycerin (placebo) suppositories 30 min before ESWL.
In the rectal indomethacin and placebo groups, post-ESWL pancreatitis developed in 9% and in 12% of the patients, respectively (relative risk 0·71).
Transient adverse events occurred in 34% and 37% of the patients in the rectal indomethacin group and placebo group, respectively, with asymptomatic hyperamylasemia being the most common (28% vs 29%).
The incidence of other complications and transient adverse events did not differ between groups.
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