{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T11:34:47Z","timestamp":1790249687291,"version":"4.1.0"},"reference-count":0,"publisher":"Georg Thieme Verlag KG","issue":"04","license":[{"start":{"date-parts":[[2019,4,2]],"date-time":"2019-04-02T00:00:00Z","timestamp":1554163200000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endosc Int Open"],"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background and study aims\u2002Endoscopic retrograde cholangiopancreatography (ERCP) is the primary therapeutic procedure for treatment of diseases that affect the biliary tree and pancreatic duct. While the therapeutic success rate of ERCP is high, the procedure can cause complications, such as acute pancreatitis (PEP), bleeding, and perforation. This meta-analysis aimed to assess the efficacy of nonsteroidal anti-inflammatory drugs (NSAIDs) in preventing PEP following (ERCP).<\/jats:p><jats:p>\n          Materials and methods\u2002We searched databases, such as MEDLINE, Embase, and Cochrane Central Library. Only randomized controlled trials (RCTs) that compared the efficacy of NSAIDs and placebo for the prevention of PEP were included. Outcomes assessed included incidence of PEP, severity of pancreatitis, route of administration, and type of NSAIDs.<\/jats:p><jats:p>\n          Results\u2002Twenty-one RCTs were considered eligible with a total of 6854 patients analyzed. Overall, 3427 patients used NSAIDs before ERCP and 3427 did not use the drugs (control group). In the end, 250 cases of acute pancreatitis post-ERCP were diagnosed in the NSAIDs group and 407 cases in the placebo group.\u200aRisk for PEP was lower in the NSAID group (risk difference (RD): \u22120.05; 95\u200a% confidence interval (CI): \u22120.07 to\u200a\u2013\u200a0.03; number need to treat (NNT), 20; P\u200a&lt;\u200a0.05). Use of NSAIDs effectively prevented mild pancreatitis compared with use of placebo (2.5\u200a% vs. 4.1\u200a%; 95\u200a% CI, \u22120.05 to\u200a\u2013\u200a0.01; NNT, 33; P\u200a&lt;\u200a0.05), but the information on moderate and severe PEP could not be completely elucidated. Only rectal administration reduced incidence of PEP (6.8\u200a% vs. 13\u200a%; 95\u200a% CI, \u22120.10 to\u200a\u2013\u200a0.04; NNT, 20; P\u200a&lt;\u200a0.05). Furthermore, only diclofenac or indomethacin use was effective in preventing PEP.<\/jats:p><jats:p>\n          Conclusions\u2002Rectal administration of diclofenac and indomethacin significantly reduced risk of developing mild PEP. Further RCTs are needed to compare efficacy between NSAID administration pathways in prevention of PEP after ERCP.<\/jats:p>","DOI":"10.1055\/a-0862-0215","type":"journal-article","created":{"date-parts":[[2019,4,3]],"date-time":"2019-04-03T01:02:01Z","timestamp":1554253321000},"page":"E477-E486","source":"Crossref","is-referenced-by-count":61,"title":["Nonsteroidal anti-inflammatory drugs versus placebo for post-endoscopic retrograde cholangiopancreatography pancreatitis: a systematic review and meta-analysis"],"prefix":"10.1055","volume":"07","author":[{"given":"Juan","family":"Serrano","sequence":"additional","affiliation":[{"name":"Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo \u2013 HC\/FMUSP, Gastrointestinal Endoscopy Unit, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diogo","family":"de Moura","sequence":"additional","affiliation":[{"name":"Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo \u2013 HC\/FMUSP, Gastrointestinal Endoscopy Unit, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wanderley","family":"Bernardo","sequence":"additional","affiliation":[{"name":"Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo \u2013 HC\/FMUSP, Gastrointestinal Endoscopy Unit, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Igor","family":"Ribeiro","sequence":"additional","affiliation":[{"name":"Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo \u2013 HC\/FMUSP, Gastrointestinal Endoscopy Unit, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomazo","family":"Franzini","sequence":"additional","affiliation":[{"name":"Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo \u2013 HC\/FMUSP, Gastrointestinal Endoscopy Unit, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo","family":"de Moura","sequence":"additional","affiliation":[{"name":"Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo \u2013 HC\/FMUSP, Gastrointestinal Endoscopy Unit, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vitor","family":"Brunaldi","sequence":"additional","affiliation":[{"name":"Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo \u2013 HC\/FMUSP, Gastrointestinal Endoscopy Unit, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne","family":"Salesse","sequence":"additional","affiliation":[{"name":"Pontif\u00edcia Universidade Cat\u00f3lica de S\u00e3o Paulo \u2013 PUC\/SP, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulo","family":"Sakai","sequence":"additional","affiliation":[{"name":"Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo \u2013 HC\/FMUSP, Gastrointestinal Endoscopy Unit, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo","family":"De Moura","sequence":"additional","affiliation":[{"name":"Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo \u2013 HC\/FMUSP, Gastrointestinal Endoscopy Unit, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2019,4,2]]},"container-title":["Endoscopy International Open"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-0862-0215.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,5,6]],"date-time":"2019-05-06T21:23:14Z","timestamp":1557177794000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-0862-0215"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,4]]},"references-count":0,"journal-issue":{"issue":"04","published-online":{"date-parts":[[2019,3,15]]},"published-print":{"date-parts":[[2019,4]]}},"URL":"https:\/\/doi.org\/10.1055\/a-0862-0215","relation":{},"ISSN":["2364-3722","2196-9736"],"issn-type":[{"value":"2364-3722","type":"print"},{"value":"2196-9736","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,4]]}}}