Rectal Indomethacin in Preventing Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis: An Updated Meta-Analysis with Trial Sequential Analysis.

ABSTRACT:

Introduction

Acute pancreatitis is a significant complication of endoscopic retrograde cholangiopancreatography (ERCP) with no established prevention strategy. Recent studies suggest that rectal indomethacin may reduce the incidence of post-ERCP pancreatitis (PEP), but its effectiveness varies with patient risk levels and the concurrent use of pancreatic stenting. This updated meta-analysis evaluates the efficacy of rectal indomethacin in preventing PEP.

Methods

A systematic search of PubMed, Embase, and Scopus up to April 2025 identified randomized controlled trials (RCTs) comparing rectal indomethacin with placebo for PEP prevention. Random-effects meta-analysis, meta-regression, and subgroup analysis were conducted using the R Meta package v8.0-2. Cochrane's ROB2 and Egge

SUBMITTER: Sawaf B 

PROVIDER: S-EPMC12668724 | biostudies-literature | 2025

REPOSITORIES: biostudies-literature