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Rectal administration of NSAIDs in the prevention of post-ERCP pancreatitis: a complementary meta-analysis
  1. M-H Zheng1,
  2. H H-X Xia2,
  3. Y-P Chen1
  1. 1
    Department of Infection and Liver Diseases, the First Affiliated Hospital of Wenzhou Medical College, Wenzhou, China
  2. 2
    Novartis Pharmaceutics Corporation, East Hanover, New Jersey, USA
  1. Professor Y-P Chen, Department of Infection and Liver Diseases, The First Affiliated Hospital of Wenzhou Medical College, No. 2 Fuxue Lane, Wenzhou, Zhejiang, China; ypchen77{at}hotmail.com

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As physicians with a long-time interest in the pharmacoprophylaxis of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP), we greatly enjoyed reading the excellent meta-analysis performed by Elmunzer et al (Gut 2008;57:1262–7) based on four randomised clinical trials (RCTs). The analysis demonstrated a pooled relative risk (RR) for PEP of 0.36 (95% confidence interval (CI) 0.22 to 0.60) after prophylactic rectal administration of non-steroidal anti-inflammatory drugs (NSAIDs), with a relative risk (RR) of 0.30 (95% CI 0.01 to 0.76) for moderate and severe pancreatitis. The authors concluded that rectal administration of NSAIDs is effective in preventing PEP. While these results have significant clinical implications, several issues remain unsolved. For …

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