The Efficacy of Ringer lactate and Sublingual Nitrates vs Indomethacin to Reduce Post-ERCP Pancreatitis: A Review Article

Abstract

Background: Inflammation in pancreas usually happens as a complication after endoscopic retrograde cholangiopancreatography (ERCP) in 16% from patients. Many studies confirmed this incidence rate of pancreatitis. Some special intervention pre-, post-operative and also during may decrease the incidence rate of pancreatitis after cholangiopancreatography, as well as mortality rate. Proper history taking and physical examination about risk factors of procedure related risks may help in determining the proper patients. Most post-endoscopy pancreatitis (PEP) complications are mild to moderate inflammation only. The defined pathophysiology of PEP is initially damaged activation of drainage of duct of pancreas which secrets phospholipase A2, then prostaglandin, and prostacyclin then finally, ischemic attack for pancreatic cells.

Objectives: This study aimed to compare between the efficacy of Ringer lactate and sublingual nitrates vs indomethacin to reduce post-ERCP pancreatitis

Methods: The databases were searched for articles published in English in 3 data bases [PubMed, Google scholar and science direct]. Post-ERCP Pancreatitis (and, or, not) had been used such as [Ringer lactate and sublingual nitrates vs indomethacin] and in peer-reviewed articles between January 2008 and October 2020.

Results: There’re some pharmaceutical actions using pharmacological agentsthat may help in preventing post-operative or after endoscope inflammation of pancreas. Latest information suggested ringer lactate and sublingual nitrates to decrease the danger of post-endoscopic retrograde cholangiopancreatography pancreatitis (post-ERCP) in vulnerable group. Another data added that pancreatic stents may benefit in preventing this problem.

Conclusion: A blend of ringer lactate with sublingual nitrate is substantially more effective compared to indomethacin without help from anyone else in view of the assurance against pancreatitis following ERCP.