Endoscopy 2021; 53(S 01): S6
DOI: 10.1055/s-0041-1724263
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ESGE Days 2021 Oral presentations
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Lactated Ringer’s Solution in Combination with Rectal Indomethacin for Prevention of Post-ERCP Pancreatitis: A Prospective Randomized, Double-Blinded, Controlled Trial

K Amalou
1   Algiers University of Medicine, Gastroenterology Military Central Hospital, Algiers, Algeria
,
F Belghanem
1   Algiers University of Medicine, Gastroenterology Military Central Hospital, Algiers, Algeria
,
A Bousseloub
1   Algiers University of Medicine, Gastroenterology Military Central Hospital, Algiers, Algeria
,
I Ararem
2   Algiers University of Medicine, Epidemilogy Military Central Hospital, Algiers, Algeria
,
D KEZOULA
3   Algiers University of Medecine, Gastroenterology, Military Central Hospital, Algiers, Algeria
,
MT MEDKOUR
3   Algiers University of Medecine, Gastroenterology, Military Central Hospital, Algiers, Algeria
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    Aims Prospective data have shown the benefit of rectal indomethacin (IND) for preventing post-ERCP pancreatitis (PEP). Recents pilot studies demonstrated a lower incidence of PEP after an 8-hour lactated Ringer’s solution (LR) infusion. The aim of this study was to evaluate the efficacy of IND with or without bolus LR in patients at high-risk for PEP.

    Methods In this randomized, double-blinded controlled trial, we assigned patients to LR, IND, or LR + IND. Each liter of fluid infusion was completed within 30 minutes. Patients were determined high-risk based established criterion and excluded if they had pancreatitis, contraindications to IND, or signs of volume overload. Our primary outcome was PEP, defined by standardized criterion. Our secondary outcomes were severe acute pancreatitis, localized adverse events, death, length of stay, and readmission.

    Results Our sample consisted of 210 patients (70 per group) who completed follow-up at 24 hours and at 30 days post-ERCP. All patients had at least 1 high-risk criterion for PEP, and 59 % had >1. PEP occurred in 5 patients (7 %) in the LR + IND versus 12 (17 %) in the LR group (P =  0.04), and 6 (8 %) in the IND group (P =  0.06). Readmission rates were lower in the LR + IND group (2 [2 %]) versus the LR group (7 [10 %]; P =  0.03). No differences were found between the other study groups. There was 1 case of severe pancreatitis (LR+IND), 2 in LR group and 1 in IND group.

    Conclusions In patients at high risk for PEP, LR + IND reduced the incidence of PEP and readmission rates compared with LR or IND alone.

    Citation: Amalou K, Belghanem F, Bousseloub A et al. OP3 LACTATED RINGER’S SOLUTION IN COMBINATION WITH RECTAL INDOMETHACIN FOR PREVENTION OF POST-ERCP PANCREATITIS: A PROSPECTIVE RANDOMIZED, DOUBLE-BLINDED, CONTROLLED TRIAL. Endoscopy 2021; 53: S6.


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    Publication History

    Article published online:
    19 March 2021

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