Rectal indomethacin to prevent pancreatitis after extracorporeal shock wave lithotripsy (RIPEP): A single-center, double-blind, randomized, placebo-controlled trial
The Lancet: Gastroenterology & Hepatology Jan 27, 2022
Findings demonstrate the efficacy as well as safety of pre-procedural administration of rectal indomethacin in decreasing the incidence of post-extracorporeal shock wave lithotripsy (ESWL) pancreatitis.
In this double-blind, randomized, placebo-controlled trial, a total of 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 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 occurred in 60 (9%) patients and in 84 (12%) patients, respectively (relative risk 0·71).
In the rectal indomethacin and placebo groups, transient adverse events were experienced by 34% and 37% of the patients, respectively, with asymptomatic hyperamylasemia being the most common (28% vs 29% patients).
The incidence of other complications and transient adverse events did not differ between groups.
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