SynthesisDigestive diseases (Basel, Switzerland)2025
Rectal Indomethacin in Preventing Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis: An Updated Meta-Analysis with Trial Sequential Analysis.
Synthesis in Digestive diseases (Basel, Switzerland), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07661498 (Indomethacin vs. no Indomethacin for Patients Undergoing Biliary ERCP With Prior Biliary Sphincterotomy), which is not on this map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Indomethacin vs. no Indomethacin for Patients Undergoing Biliary ERCP With Prior Biliary Sphincterotomy
Who cites it
1 citing paper in PubMed.
- Confounding by Indication in Real-World Indomethacin Use for Post-ERCP Pancreatitis: Implications for Severity and Cost.Digestive diseases and sciences · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionAcute pancreatitis is a significant complication of endoscopic retrograde cholangiopancreatography (ERCP) with no established prevention strategy. Recent studies suggest that rectal indomethacin may reduce the incidence of post-ERCP pancreatitis (PEP), but its effectiveness varies with patient risk levels and the concurrent use of pancreatic stenting. This updated meta-analysis evaluates the efficacy of rectal indomethacin in preventing PEP.
methodsA systematic search of PubMed, Embase, and Scopus up to April 2025 identified randomized controlled trials (RCTs) comparing rectal indomethacin with placebo for PEP prevention. Random-effects meta-analysis, meta-regression, and subgroup analysis were conducted using the R Meta package v8.0-2. Cochrane's ROB2 and Egger's regression test are used to assess the risk of bias.
resultsThe analysis included 15 RCTs representing a total of 4,962 patients. Rectal indomethacin significantly reduced the incidence of PEP compared to placebo (risk ratio [RR]: 0.58; 95% confidence interval [CI], 0.45-0.73; p < 0.01) with no increased risk for bleeding complications (RR: 0.95, 95% CI: 0.64-1.41, p = 0.76). Subgroup analysis showed that indomethacin was effective, especially when given concurrently with a pancreatic stent (RR: 0.4539, 95% CI: 0.26-0.79). However, a high risk of bias was observed in nearly 25% of the overall assessment; there was evidence of a small-study effect, as suggested by Egger's regression test (p < 0.01).
conclusionProphylactic rectal indomethacin appears to be effective in preventing PEP, with no increased risk for bleeding. Future studies should focus on combining other prophylactic options to achieve better prevention of PEP.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.