Prevention of pancreatitis by flurbiprofen axetil after endoscopic retrograde cholangiopancreatography

CHEN Na; HUANG Anning; DING Lili; LIU Liping

PDF(527 KB)

Medical Journal of the Chinese People Armed Police Forces ›› 2017, Vol. 28 ›› Issue (12) : 1213-1215.

ORIGINAL ARTICLES

Prevention of pancreatitis by flurbiprofen axetil after endoscopic retrograde cholangiopancreatography

CHEN Na, HUANG Anning, DING Lili, LIU Liping

Author information +

History +

Abstract

Objective To investigate the role of flurbiprofen axetil in preventing post-ERCP pancreatitis(PEP) in patients after endoscopic retrograde cholangiopancreatography(ERCP).Methods One hundred and ten ASA Ⅰ or Ⅱ patients who had received ERCP were randomly assigned to the group of intravenous injection of 1.5 mg/kg flurbiprofen axetil (flurbiprofen group) and saline alone (placebo group). The serum amylase was detected 6 and 24 h after operation,while the incidence of PEP and postoperative hyperamylasemia was compared between the two groups.Results The serum amylase level in flurbiprofen group was significantly lower than that in control group 6 h and 24 h after ERCP [(225±67.83) U/L vs (379±112.61) U/L,(127±92.77) U/L vs (186±97.28) U/L](P＜0.05). 11.1%(6/54) of the patients in control group had PEP compared with 0.0%(0/56)in flurbiprofen group. 35.19%(19/54) of the patients in control group and 14.9%(8/56)in flurbiprofen group had hyperamylasemia 6 h after ERCP,and the incidence of hyperamylasemia was 20.37%(11/54)in control group and 5.36%(3/56)in flurbiprofen group 24 h after ERCP, so there was significant difference between the two groups(P＜0.05).Conclusions Flurbiprofen axetil is an effective, safe and easy method for prevention of PEP.

Key words

flurbiprofen axetil / endoscopic retrograde cholangiopancreatography / hyperamylasemia / post-ERCP pancreatitis

Cite this article

EndNote

Ris (Procite)

Bibtex

Download Citations

CHEN Na, HUANG Anning, DING Lili, LIU Liping. Prevention of pancreatitis by flurbiprofen axetil after endoscopic retrograde cholangiopancreatography[J]. Medical Journal of the Chinese People Armed Police Forces. 2017, 28(12): 1213-1215

References

[1] Freeman M L, Nelson D B, Sherman S,et al. Complications of endoscopic biliary sphincterotomy [J].N Engl J Med,1996, 335(13): 909-918.
[2] Cotton P B, Lehman G, Vennes J,et al. Endoscopic sphincterotomy complications and their management: an attempt at consensus [J]. Gastrointest Endosc,1991, 37(3): 383-393.
[3] Freeman M L, DiSario J A, Nelson D B,et al. Risk factors for post-ERCP pancreatitis: a prospective, multicenter study [J]. Gastrointest Endosc, 2001, 54(4): 425-434.
[4] Elmunzer B J, Scheiman J M, Lehman GA,et al. A randomized trial of rectal indomethacin to prevent post-ERCP pancreatitis [J]. N Engl J Med, 2012,366(15): 1414-1422.
[5] Freeman M L. Adverse outcomes of ERCP [J]. Gastrointest Endosc, 2002,56(6 Suppl):S273-282.
[6] Gottlieb K, Sherman S. ERCP and endoscopic biliary sphincterotomy-induced pancreatitis [J]. Gastrointest Endosc Clin N Am,1998, 8(1): 87-114.
[7] Whitcomb D C. Acute pancreatitis: molecular biology update[J]. J Gastrointest Surg,2003, 7(8): 940-942.
[8] Gross V, Leser H G, Heinisch A,et al. Inflammatory mediators and cytokines: new aspects of the pathophysiology and assessment of severity of acute pancreatitis? [J]. Hepatogastroenterology, 1993,40(6): 522-530.
[9] Fujita Y,Hasegawa S,Kato Y, et al. Intravenous injection of low-dose flurbiprofen axetil for preventing post-ERCP pancreatitis in high-risk patients: an interim analysis of the trial [J]. Endosc Int Open, 2016, 4(10): 1078-1082
[10] 熊江琴,陈世彪,刘添银.丙泊酚复合不同镇痛药用于内镜下经胰胆管造影术的临床研究 [J].临床麻醉学杂志,2012,28(2):125-127.
[11] Vandervoort J, Soetikno R M, Tham T C,et al. Risk factors for complications after performance of ERCP [J]. Gastrointest Endosc, 2002, 56(5): 652-656.
[12] Rabenstein T, Hahn E G. Post-ERCP pancreatitis: new momentum[J]. Endoscopy, 2002, 34(4): 325-329.
[13] Hofbauer B, Saluja A K, Lerch M M,et al. Intra-acinar cell activation of trypsinogen during cerulean-induced pancreatitis in rats [J]. Am J Physiol,1998, 275(1): 352-362.
[14] Banks P A, Freeman M L. Practice guidelines in acute pancreatiti [J]. Am J Gastroenterol, 2006, 101(10): 2379-2400.
[15] Feurer M E,Adler D G.Post-ERCP pancreatitis:review of current preventive strategies[J].Curr Opin Gastroenterol,2012,28(3):280-286.
[16] Dumonceau J M, Andriulli A, Deviere J, et al. European Society of Gastrointestinal Endoscopy(ESGE) guideline: prophylaxis of post-ERCP pancreatitis[J]. Endoscopy, 2010, 42(6): 503-515.
[17] Dumonceau J M, Andriulli A, Elmunzer B J,et al. prophylaxis of post-ERCP pancreatitis: European Society of Gastrointestinal Endoscopy(ESGE) guideline-updated June 2014[J]. Endoscopy, 2014,46(9):799-815.
[18] Akbar A, Abu Dayyeh B K, Baron T H, et al.Rectal nonsteroidal anti-inflammatory drugs are superior to pancreatic duct stents in preventing pancreatitis after endoscopic retrograde cholangiopancreatography:a network meta-analysis [J].Clin Gastroenterol Hepatol, 2013,11(7):778-783
[19] 段砺瑕,李晓玲.氟比洛芬酯注射液的药理作用及临床应用[J].中国新药杂志 , 2004, 13(9):851-852.
[20] Debenedet A T, Raghunathan T E, Wing J J,et al. Alcohol use and cigarette smoking as risk factors for post-endoscopic retrograde cholangiopancreatographypancreatitis [J]. Clin Gastroenterol Hepatol,2009,7(3) : 353-358.