The Efficacy of Pancreatic Duct Stenting With Rectal Indomethacin in Preventing Post-ERCP Pancreatitis
The Efficacy of Pancreatic Duct Stenting With Rectal Indomethacin in Preventing Post-ERCP Pancreatitis
With the development of endoscopic technology, ERCP has been widely used in the diagnosis and
 treatment of pancreatobiliary diseases, and has become the first treatment for most of the
 biliary and pancreatic diseases. Postoperative ERCP pancreatitis (PEP) is the most common and
 serious complication after ERCP. The purpose of this study was to explore methods for
 preventing postoperative pancreatitis.

 1. Participants: Patients with high-risk factors associated with PEP were included in the
 no-obvious patients who underwent therapeutic ERCP in our hospital from June 2018 to
 December 2019.

 2. Research methods: Patients were randomly divided into indometacin suppositories,
 indomethacin suppositories and pancreatic stents.

 3. Statistical methods: SPSS 13.0 statistical software was used. The measurement data was
 expressed as x± s, and t-test or non-parametric test was used. Chi-square test was used
 for count data.
Patients with high risk factors for PEP who will be examined and diagnosed by ERCP at
 2018.06-2019.12 in the First People's Hospital of Hangzhou are randomly divided into two
 groups.

 2. Record the relevant indicators of each group of patients: 1 before and after surgery 3,
 12, 24 h serum amylase changes 2 patients with abdominal pain, abdominal distension, fever,
 vomiting and abdominal signs of change; 3 hospital days; 4 CT severity index (CT severity
 Index, CTSI score: Balthazar 5 scores were scored as 0 to 4 points; according to the scope of
 necrosis was divided into no, <33%, 33% to 50%,> 50%, respectively rated as 0, 2, 4 and 6
 points. Addition of the two scores is the CTSI score. 5 According to the diagnostic criteria
 for postoperative ERCP pancreatitis, PEP will be diagnosed in patients with persistent
 abdominal pain within 24 hours after ERCP and blood amylase increase by more than 3 times the
 normal value. Observed 2 groups of post-ERCP pancreatitis, severe pancreatitis and adverse
 events Incidence.

 3. Analyze and compare the above indicators and observe the effect of the two methods on the
 reduction of blood amylase level and incidence of pancreatitis. It is clear that rectal
 administration of preoperative indomethacin suppository has the same protection against PEP
 as pancreatic stenting effect.
Inclusion Criteria:

 Age over 18 years old,gender is not limited; Preoperative blood amylase is normal; PEP risk
 factors during surgery:difficulty in intubation,needle knife incision,intraoperative
 intubation into the pancreatic duct more than 3 times,the contrast agent in the pancreatic
 duct is filled; The research procedure is willing to be followed and the informed consent
 is signed.

 Exclusion Criteria:

 Myocardial infarction occurred within 3 months; Insufficiency of renal function;
 Conventional gastrectomy; Preoperative state of shock,such as hypotension(systolic blood
 pressure less than 90mmHg); Pregnancy and lactation; Allergic to NSAIDs drugs; Partially or
 completely restricted in the ability to exercise consciousness,without self-determination
 ability; Are participating in other clinical observation trials or have participated in
 other clinical trials within 60 days; Cases considered unsuitable by the investigator.