SynthesisBMC gastroenterology2017
How to select patients and timing for rectal indomethacin to prevent post-ERCP pancreatitis: a systematic review and meta-analysis.
Synthesis in BMC gastroenterology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07599605 (Efficacy of Rectal Indomethacin Plus Aggressive Hydration as Prophylaxis to Prevent Post-ERCP Pancreatitis at a Secondary-Care Teaching Hospital), which is not on this map. Cited by 13 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Efficacy of Rectal Indomethacin Plus Aggressive Hydration as Prophylaxis to Prevent Post-ERCP Pancreatitis at a Secondary-Care Teaching Hospital: A Randomized Controlled Trial.
Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 37 citations in OpenAlex.
- Rectal Indomethacin in Preventing Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis: An Updated Meta-Analysis with Trial Sequential Analysis.Digestive diseases (Basel, Switzerland) · 2025Pooled it
- What is impact of nonsteroidal anti-inflammatory drugs in the prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis: a meta-analysis of randomized controlled trials.BMC gastroenterology · 2018Pooled it
- Ketorolac and Predicted Severe Acute Pancreatitis: A Randomized, Controlled Clinical Trial.Clinical medicine & research · 2022Trial
- Can topical epinephrine application to the papilla prevent pancreatitis after endoscopic retrograde cholangiopancreatography? Results from a double blind, multicentre, placebo controlled, randomised clinical trial.BMJ open gastroenterology · 2021Trial
- Trial
- Safety and feasibility of omitting routine endoscopic nasobiliary drainage after ERCP for common bile duct stones: a prospective comparative study.BMC surgery · 2026Article
- Non-Steroidal Anti-Inflammatory Drugs Administered Intra-Articularly in Temporomandibular Joint Disorders: A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2024Review
- Article
- Comparison of one-stage treatment versus two-stage treatment for the management of patients with common bile duct stones: A meta-analysis.Frontiers in surgery · 2023Review
- Optimal timing of rectal diclofenac in preventing post-endoscopic retrograde cholangiopancreatography pancreatitis.Endoscopy international open · 2022Article
- Effectiveness of supraglottic ventilation by transtracheal catheter for painless ERCP.American journal of translational research · 2021Article
- Update on the Prevention of Post-ERCP Pancreatitis.Current treatment options in gastroenterology · 2018Review
- Recent advances in understanding and managing acute pancreatitis.F1000Research · 2018Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAcute pancreatitis is a severe complication of endoscopic retrograde cholangiopancreatography (ERCP). Previous meta-analyses have shown that indomethacin effectively prevents this complication; however, the data are limited. We performed a systematic review and meta-analysis to clarify the applications for rectal indomethacin.
methodsA systematic search was performed in June 2016. Human prospective, randomized, placebo-controlled trials that compared rectally administered indomethacin with a placebo for the prevention of post-ERCP pancreatitis (PEP) were included. A meta-analysis was performed using a random-effects model to assess the outcomes (PEP) using Review Manager 5.0.
resultsSeven randomized controlled trials met the inclusion criteria (n = 3013). The overall incidence of PEP was significantly lower after prophylactic administration of rectal indomethacin than after administration of the placebo (RR, 0.58, 95% CI, 0.40-0.83; P = 0.004). A subgroup analysis was performed for rectal indomethacin administration compared to a placebo in high-risk patients (RR, 0.46; 95% CI, 0.32-0.65; P < 0.00001) and average-risk patients (RR, 0.75; 95% CI, 0.46-1.22; P = 0.25) and for administration before ERCP (RR, 0.56; 95% CI, 0.39-0.79; P = 0.001) and after the procedure (RR, 0.61; 95% CI, 0.26-1.44; P = 0.26).
conclusionsThis meta-analysis indicated that prophylactic rectal indomethacin is not suitable for all patients undergoing ERCP but it is safe and effective to prevent PEP in high-risk patients. In addition, rectal indomethacin administration before ERCP is superior to its administration after ERCP for the prevention of PEP.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.