Prophylactic Effect of Pancreatic Duct Stent and Diclofenac in Patients at High Risk for Post-ERCP Pancreatitis

Abstract

Objective: To investigate the preventive effect of pancreatic duct stent combined with diclofenac on post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis in high-risk populations, and to evaluate its impact on clinical indicators. Methods: A total of 95 high-risk patients for post-ERCP pancreatitis treated at the hospital from January 2022 to January 2025 were enrolled and randomly divided into a combination group (pancreatic duct stent+diclofenac suppository) of 43 cases and a diclofenac group of 52 cases. A 4-7 cm short pancreatic duct stent was used, and the diclofenac group received 50 mg diclofenac at 1 h before surgery and after surgery. The incidence of post-ERCP pancreatitis, VAS score, length of hospital stay, serum amylase level, WBC, CRP, and ERCP-related complications were observed and compared between the two groups. Results: The number of patients without pancreatitis in the combination group was greater than that in the diclofenac group, and the length of hospital stay was shorter than that in the diclofenac group (P<0.05). There was no statistically significant difference in VAS scores between the two groups (P>0.05). At 24 h after surgery, serum amylase and CRP increased in both groups, and the serum amylase and CRP in the combination group were lower than those in the diclofenac group (P<0.05). There was no statistically significant difference in WBC within or between the two groups (P>0.05). The complication rate in the combination group was 2.33%, lower than the 15.38% in the diclofenac group (P<0.05). Conclusion: Pancreatic duct stent combined with diclofenac can synergistically reduce the incidence and severity of pancreatitis in high-risk patients, improve inflammatory indicators, and shorten hospital stay, without significantly increasing patient pain, and reduces the incidence of ERCP-related complications. It is recommended as a first-line preventive strategy for post-ERCP pancreatitis.