Korean J Intern Med.  2020 May;35(3):535-543. 10.3904/kjim.2020.069.

Prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis with rectal non-steroidal anti-inflammatory drugs

  • 1Department of Internal Medicine, Inje University Seoul Paik Hospital, Seoul, Korea
  • 2Division of Gastroenterology, Chung-Ang University College of Medicine, Seoul, Korea
  • 3Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, IN, USA


Acute pancreatitis is the most common and feared adverse event associated with performance of endoscopic retrograde cholangiopancreatography (ERCP). Unremitting effort has been made for over 40 years to minimize the frequency and severity of this complication. Recently, the use of rectal non-steroidal anti-inflammatory drugs (NSAIDs) have opened a new era for its prevention. This review focuses on the role of NSAIDs in pancreatitis, the pharmacokinetics of these agents, and summarizes the results of clinical trials with rectal NSAIDs alone and combination regimens in the prevention of post-ERCP pancreatitis.


Cholangiopancreatography, endoscopic retrograde; Pancreatitis; Anti-inflammatory agents, non-steroidal
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