Efficacy and Safety of Indomethacin for the Prevention of Post-ERCP Pancreatitis: “A Comprehensive Systematic Review and Meta-Analysis”

Abstract

Background: Post-Endoscopic Pancreatitis (PEP) is a common complication in the surgical settings, particularly among high-risk individuals. Non- steroidal anti-inflammatory drugs (NSAIDs) have been proposed as a prophylactic measure to reduce the incidence of PEP. This studyevaluates theefficacy and safety of indomethacin for the prevention of PEP.

Methods: A systematic search of relevant studies was conducted using PubMed, Scopus, Cochrane Library, and Elsevier databases. The Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guidelines were followed as for the search strategy. Out of 125 initially ide

after ERCP, the mean difference between the indomethacin and placebo groups was -0.03 (95% CI:

-0.23 to 0.19; p = 0.76), also indicating no statistically significant difference.

Conclusion: Indomethacin did not demonstrate a significant effect in preventing PEP or reducing its complications. Further randomized controlled trials (RCTs) with larger sample sizes are warranted to provide more robust evidence regarding the efficacy and safety of indomethacin in PEP prophylaxis.