ObjectiveTo investigate the molecular mechanism of indometacin preventing pancreatitis after endoscopic retrograde cholangiopancreatography(ERCP).
MethodsSeventy patients scheduled by ERCP were randomly divided into the control group and observation group(35 cases each group).The observation group and control group were treated with 100 mg of indomethacin suppository and placebo suppository intrarectal application before operation, respectively.The incidence rates of postoperative hyperamylasemia and pancreatitis in two groups were observed, and the serum levels of prostaglanding E2(PGE2), interleukin-17(IL-17) and tumor necrosis factor-α(TNF-α) in two groups were detected before operation and after 3 h and 24 h of operation.
ResultsThe postoperative pancreatitis in observation group(1 case)was lower than that in control group(8 cases)(P < 0.05).There was not statistical significance in the incidence rate of the total complications between two groups(P>0.05).There was not statistical significance in the levels of PGE2, IL-17 and TNF-α between two groups before operation(P>0.05).The levels of PGE2, IL-17 and TNF-α in observation group after 3 h of operation were lower than those in control group(P < 0.05).After 24 h of operation, the levels of IL-17 and TNF-α in observation group were lower than those in control group(P < 0.05 and P < 0.01), and the difference of the level of PGE2 between two groups was not statistically significant(P>0.05).The differences of the levels of IL-17 and TNF-α in control group between before and after operation were statistically significant(P < 0.01 and P < 0.05), but which in observation group was not statistically significant(P>0.05).
ConclusionsIndomethacin suppository preoperative intrarectal application can effectively reduce the incidence rate of pancreatitis after ERCP, which may be related to the decreasing levels of PGE2, IL-17 and TNF-α.
DownLoad: