Associate 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 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.
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