ABSTRACT
Objective: To evaluate the effectiveness of rectal non-steroidal anti-inflammatory drugs [NSAIDs] using diclofenac in preventing pancreatitis following ERCP
Methodology: It was a randomized, double blinded, placebo controlled study carried out at Surgical Unit-l, Holy Family Hospital, Rawalpindi from May 2013 to April 2014. A total of 108 patients were included and randomly assigned in each of study and placebo groups. Group I patients received 100 mg of diclofenac per rectally while group II patients received a glycerine suppository per rectally [placebo] before the start of ERCP. Post ERCP pancreatitis [PEP] was diagnosed by clinical evaluation and raised serum amylase levels after four hours of the procedure in both groups [study vs control]
Results: Out of 108 patients 32 were males and 76 were females. Mean age was 46.09 +/- 12.31 in group I, while it was 42.93 +/- 14.69 in Group II. Mean serum amylase level, 4 hours after ERCP, was 184.70 +/- 36.34 in the diclofenac group, while it was 388.20 +/- 57.27 IU/L in the control group. Thirty one patients were diagnosed with Post ERCP pancreatitis, out of which nine patients belonged to the study group and twenty two were of the control group [P = 0.000]
Conclusion: Per-rectal administration of diclofenac suppository prior to ERCP results in significant reduction in the frequency of ERCP induced pancreatitis
ABSTRACT
Experience with Laparosopic assisted Right Hemicolectomy is presented. Prospective study. Surgical Unit-I, Holy Family Hospital, Rawalpindi, Pakistan. 2010 to 2014. 20 patients underwent laparosopic assisted right hemicolectomy. Duration of operation, postoperative pain, duration of post-operative analgesia, and frequency of surgical site infection and length of hospital stay were noted. There were 13 male and 7 female patients with the age range of 25-70 years [45 +/- 11years]. Eleven [11] patients were suffering from carcinoma colon wheras nine [09] were suffering from Tuberculosis. Mean operative time was about 92 minutes. Only four opiod injections were required as post-operative analgesia. Oral intake was started after 24 hours. The mean length of hospital stay was 5.5 days with no case of surgical site infection. Laparoscopic assisted right hemicolectomy is a safe and viable option in our setup