ABSTRACT
OBJECTIVES: The aim of the present study was to assess the appropriate administration dose of non-steroidal anti-inflammation drugs to prevent pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP). Importantly, the 100â mg dose of diclofenac recommended in Western countries has not been permitted in Japan. DESIGN: A retrospective study. SETTINGS: A single centre in Japan. PARTICIPANTS: This study enrolled patients who underwent ERCP at the Department of Gastroenterology, Osaka Saiseikai Senri Hospital, from April 2011 through June 2013, and who received either a 25 or a 50â mg dose of rectal diclofenac after ERCP. PRIMARY OUTCOME MEASURE: The occurrence of post-ERCP pancreatitis (PEP). A multivariate regression model was used to assess the effect of the 50â mg dose (the 50â mg group) of rectal diclofenac and to compare it to the occurrence of PEP referring to the 25â mg group. RESULTS: A total of 155 eligible patients received either 25â mg (84 patients) or 50â mg (71 patients) doses of rectal diclofenac after ERCP to prevent PEP. The proportion of PEP was significantly lower in the 50â mg group than in the 25â mg group (15.5% (11/71) vs 33.3% (28/84), p=0.018). In a multivariate analysis, the occurrence of PEP was significantly lower in the 50â mg group than in the 25â mg group even after adjusting potential confounding factors (adjusted OR=0.27, 95% CI 0.11 to 0.70). CONCLUSIONS: From this observation, the occurrence of PEP was significantly lower among ERCP patients with the 50â mg dose of rectal diclofenac than among those with the 25â mg dose.
Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/administration & dosage , Cholangiopancreatography, Endoscopic Retrograde/adverse effects , Diclofenac/administration & dosage , Pancreatitis/prevention & control , Administration, Rectal , Aged , Aged, 80 and over , Female , Humans , Japan , Male , Middle Aged , Pancreatitis/etiology , Retrospective StudiesABSTRACT
We treated a 41-year-old man with hepatocellular carcinoma and chronic liver disease. He experienced leg edema. Following additional examinations, we diagnosed the patient with hepatocellular carcinoma and ascites with liver cirrhosis. Due to renal dysfunction, he could not undergo treatment with transcatheter arterial chemoembolization(TACE)or transcatheter arterial infusion(TAI). Therefore, he was treated with specific substance of maruyama(SSM), and survived.