Split-dose or hybrid nonsteroidal anti-inflammatory drugs and N-acetylcysteine therapy for prevention of post-retrograde cholangiopancreatography pancreatitis

Table 1 Baseline characteristics of patients in the control group and the study groups

Characteristic	Control group (n = 98)	Study group A (n = 32)	Study group B (n = 56)	P
Female	44	14	40	0.059
Male	54	18	16	0.086
Age, yr	64.47	63.56	64.50	0.976
Comorbid conditions	68	24	40	0.910
Diabetes mellitus type 2	4	0	4	0.529
Hypertension	24	10	6	0.591
Ischemic heart disease	8	6	6	0.399
Dyslipidemia	8	7	7	0.247
Hypothyroidism	0	0	4	0.093
Hepatic cirrhosis	4	0	4	0.529
Normal bilirubin pre-ERCP	20	16	14	0.066
Previous cholecystectomy	40	10	24	0.734
Dilated bile duct pre-ERCP	4	0	4	0.529

ERCP: Endoscopic retrograde cholangiopancreatography.

Table 2 Pearson’s chi-squared test to compare risk factors’ occurrence in the three study arms

PEP	Pearson’s chi-square	df	P
Existent risk factors	0.627	2	0.731, NS
Female sex	5.651	2	0.059, NS
Young age	3.030	2	0.220, NS
Normal bilirubin	5.446	2	0.066, NS
Excess contrast agent	2.409	2	0.300, NS
No. of cannulations	0.645	2	0.724, NS
PEP	1.835	2	0.399, NS

NS: Non-significant; PEP: Post-endoscopic retrograde cholangiopancreatography pancreatitis.

Table 3 Pearson’s chi-squared test comparison between the three study arms’ clinical and laboratory factors at 6 h

	Control arm	Arm 1	Arm 2	Chi-square	P
Amylasemia at 6 h				4.288	0.368
< 3 × ULN	81.6%	100.0%	85.7%
> 3 × ULN	18.4%	0.0%	14.3%
Lipasemia at 6 h				10.046	0.040
< 3 × ULN	69.4%	68.7%	71.4%
> 3 × ULN	30.6%	31.3%	28.6%
CRP at 6 h				12.165	0.058
Normal	49.0%	56.2%	57.1%
Mild increase	20.4%	12.5%	35.7%
Moderate increase	26.5%	31.2%	0.0%
Severe increase	4.1%	0.0%	7.1%
Clinico-biologic status at 6 h				0.397	0.820
PEP absent	91.8%	87.5%	92.9%
PEP	8.2%	12.5%	7.1%

Arm 1: Study group A treatment regimen;

Arm 2: Study group B treatment regimen; CRP: C-reactive peptide; ULN: Upper limit of normal; PEP: Post-endoscopic retrograde cholangiopancreatography pancreatitis.

Table 4 Pearson’s chi-squared test comparison between the three study arms’ clinical and laboratory factors at 24 h

	Control arm	Arm 1	Arm 2	Chi-square	P
Amylasemia at 24 h				11.835	0.019
< 3 × ULN	91.8%	100.0%	71.4%
> 3 × ULN	8.2%	0.0%	28.6%
Lipasemia at 24 h				9.889	0.029
< 3 × ULN	91.8%	87.5%	71.4%
> 3 × ULN	8.2%	12.5%	28.6%
CRP at 24 h				12.824	0.046
Normal	49.0%	43.8%	64.3%
Mild increase	20.4%	0.0%	7.1%
Moderate increase	22.4%	56.2%	21.4%
Severe increase	8.2%	0.0%	7.1%
Clinico-biologic status at 24 h				2.793	0.247
PEP absent	91.8%	87.5%	78.6%
PEP	8.2%	12.5%	21.4%

Arm 1: Study group A treatment regimen;

Arm 2: Study group B treatment regimen; CRP: C-reactive peptide; ULN: Upper limit of normal; PEP: Post-endoscopic retrograde cholangiopancreatography pancreatitis.