To investigate the efficacy of diclofenac sodium in preventing pancreatitis and hyperamylasemia after endoscopic retrograde cholangiopancreatography(ERCP)stone extraction, and whether it can reduce the incidence of post-ERCP pancreatitis by affecting the expression of serum prostaglandin E2(PEG2).

According to random method, 94 patients who underwent ERCP stone extraction were divided into diclofenac sodium group(48 patients were given 100 mg diclofenac sodium for anal insertion 15 minutes before operation)and control group(46 patients were given 100 mg glycerol enema for anal insertion 15 minutes before operation). Serum amylase and lipase levels of the two groups were observed before and 3 hours and 24 hours after ERCP.ELISA was used to detected the levels of serum PEG2 in the two groups.The incidences of pancreatitis and hyperamylasemia and the expression levels of serum PEG2 were compared between the two groups.

The incidence of post-ERCP pancreatitis in the diclofenac sodium group was significantly lower than that in the control group, with a statistically significant difference(P<0.05), but there was no statistically significant difference in the incidence of post-ERCP hyperamylasemia between the two groups(P>0.05). There was no statistically significant difference in PEG2 titer between the two groups before ERCP(P>0.05). The serum PEG2 titer in the diclofenac sodium group was lower than that in the control group 3 hours after ERCP, with a statistically significant difference(P<0.05). There was no statistically significant difference in serum PEG2 titer between the two groups 24 hours after ERCP, and returned to the preoperative level(P>0.05).

Diclofenac sodium can effectively prevent pancreatitis after ERCP stone extraction, which may be related to the decrease of serum PGE2 expression level.