Shielding against Acute Pancreatitis: A Revolutionary Approach with a Single Dose of Diclofenac Sodium following ERCP

Abstract

Background: Acute pancreatitis is a common and potentially serious complication following endoscopic retrograde cholangiopancreatography (ERCP). There is an unmet need for effective prophylactic therapies. The aims of this work evaluate the efficacy and safety of intravenous diclofenac sodium in reducing the incidence of post-ERCP acute pancreatitis. A prospective, randomized, double-blind, placebo-controlled trial was conducted. 300 patients undergoing ERCP were randomized to receive either 100mg diclofenac sodium or saline placebo intravenously immediately after the procedure. The primary outcome was development of acute pancreatitis within 72 hours as defined by revised Atlanta criteria. Secondary outcomes included adverse events, hospital stay and need for intervention. Diclofenac sodium resulted in a 58% relative risk reduction in acute pancreatitis compared to control (5.3% vs 12.7%, p<0.05). Exploratory analyses found it effective across all age groups and risk factor statuses. Incidence of adverse events and serious adverse events was comparable between groups. In conclusion, A single intravenous dose of diclofenac sodium following ERCP significantly reduces the incidence of post-procedural acute pancreatitis, with an excellent safety profile. This intervention holds promise for revolutionizing prevention of this debilitating complication.