Can a Single Dose Corticosteroid Reduce the Incidence of Post-ERCP Pancreatitis ?: A Randomized, Prospective Control Study
Kris Kwanngern MD*, Prawes Tiyapattanaputi MD*, Mongkol Wanitpukdeedecha MD*, Patpong Navicharern MD*
Affiliation : * Department of Surgery,Faculty of Medicine, Chulalongkorn University
Background : Acute pancreatitis is one of the complications after Endoscopic retrograde cholangio
pancreatography (ERCP) and it could be fatal. Several drugs were used to prevent or decrease this complica-
tion. Corticosteroid is one of the medications which may have such potential. It is affordable and available
everywhere.
Objectives : To compare the incidence of post-ERCP pancreatitis in patients receiving single dose corticoster-
oid prior to the procedure with that of the control group .
Research
Design : A prospective randomized controlled double-blinded study.
Materials and Methods : A total of 120 patients were randomized to receive either intravenous hydrocortisone
100 mg. or normal saline 1 hour prior to the procedure. The serum amylase levels were recorded 4 and 24
hours after the procedure. Abdominal pain and back pain were also recorded. Patients were diagnosed as
having post-ERCP pancreatitis if ones had new or worsened epigastric pain with or without radiation to the
back combined with elevation of serum amylase more than 2.5 times the upper limit.
Results : The overall incidence of pancreatitis was 6.67% with 1.64% in the study group compared with
11.86% in the control group (p = 0.031). The groups were similar with regard to age, gender, type of proce-
dure performed (diagnostic or therapeutic), difficulty of cannulation, concentration of contrast media and pre
operative amylase level.
Conclusion : The results of the present trial indicate that hydrocortisone could reduce the risk of post-ERCP
pancreatitis.
Keywords : Endoscopic retrograde cholangiopancreatographys ERCP, Steroid, Pancreatitis
