Effect of indomethacin suppositories combined with pancreatic duct stenting on population at high risk of postoperative pancreatitis
Objective:To investigate the effects of indomethacin suppositories combined with pancreatic duct stent implantation on inflammatory factors and immune function in patients with high risk of post endoscopic retrograde cholangiopancreatography(ERCP)pancreatitis(PEP).Methods:In this prospective study,234 patients at high risk of PEP who received ERCP between Jul.2022 and Jun.2023 were selected as subjects.The patients were divided into stent group(pancreatic duct stent implantation,n=80),indometha-cin suppository group(rectal administration of indomethacin suppository,n=78),and combined group(indomethacin suppository com-bined with pancreatic duct stent implantation,n=76)by envelope method.The relevant inflammatory factors,immune function before or after operation,PEP occurrence,incidence of severe PEP,symptom remission time and hospital stay of the three groups were compared.Results:Before the surgery,there was no significant difference in the levels of inflammatory factors and immune function among the three groups(P＞0.05).The levels of inflammatory factor interleukin-6,interleukin-10 and C-reactive protein in the combined group were lower than those in the stent group and indomethacin suppository group,the CD4+and CD4+/CD8+levels in the combined group were higher than the other two groups,and the CD8+level in the combined group was lower than the other two groups,and the differences were statistically significant(P＜0.05).There was no significant difference in the occurrence of PEP and the incidence of severe PEP among the three groups(P＞0.05).The duration of pain relief and hospitalization in the combined group were shorter than those in the other two groups(P＜0.05).Conclusions:Indomethacin suppository and pancreatic duct stenting can reduce the inflammation of PEP high-risk population,and improve the immune function of patients.Moreover,it can shorten the postoperative pain relief time and hospi-tal stay.
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