Editor’s Choice- Results of Tokyo Trial of Prevention of Post-ERCP Pancreatitis

Dr. Jacques DevièreAssociate Editor Jacques Devière, MD, PhD, recommends this article from the December issue “Results of the Tokyo Trial of Prevention of Post-ERCP Pancreatitis with Risperidone-2: a multicenter, randomized, placebo-controlled, double-blind clinical trial” by Rie Uchino, MD, PhD,  Hiroyuki Isayama, MD, PhD, Takeshi Tsujino, MD, PhD, Naoki Sasahira, MD, PhD, Yukiko Ito, MD, PhD, Saburo Matsubara, MD, PhD, Naminatsu Takahara, MD, Toshihiko Arizumi, MD, PhD, Nobuo Toda, MD, PhD, Dai Mohri, MD, PhD, Osamu Togawa, MD, PhD, Hiroshi Yagioka, MD, PhD, Yoshitsugu Yanagihara, PhD, Katsuyoshi Nakajima, PhD, Dai Akiyama, MD, Tsuyoshi Hamada, MD, PhD, Koji Miyabayashi, MD, PhD, Suguru Mizuno, MD, PhD, Kazumichi Kawakubo, MD, PhD, Hirofumi Kogure, MD, PhD, Takashi Sasaki, MD, PhD, Natsuyo Yamamoto, MD, PhD, Yousuke Nakai, MD, PhD, Kenji Hirano, MD, PhD, Minoru Tada, MD, PhD, and Kazuhiko Koike, MD, PhD.

This was a well-conducted randomized controlled trial on Risperidone for prevention of post-ERCP pancreatitis. Results show that Risperidone does not prevent post-ERCP pancreatitis (PEP).

This study provides another illustration of animal data suggesting a benefit for prevention which are not translated in human study. Still now only peroperative rectal NSAIDs administration (which should be used routinely) and prophylactic stenting in high risk cases have proven efficacy in reducing PEP.

Figure 1Figure 1. Flow diagram of the study.

Risperidone is ineffective in preventing PEP. Further trials should be developed with caution, be powered enough to draw firm conclusions, and should include NSAIDs in both arms investigating combined prophylactic therapy.

Find the abstract for this article here.

The information presented in Endoscopedia reflects the opinions of the authors and does not represent the position of the American Society for Gastrointestinal Endoscopy (ASGE). ASGE expressly disclaims any warranties or guarantees, expressed or implied, and is not liable for damages of any kind in connection with the material, information, or procedures set forth.

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