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NCT Number: NCT07661498

Indomethacin for Biliary ERCP Patients

This study is a randomized clinical trial evaluating the efficacy of rectal indomethacin in preventing post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis in patients undergoing biliary ERCP who have a history of prior biliary sphincterotomy. While rectal indomethacin has demonstrated benefits in preventing post-ERCP pancreatitis in high-risk patients, its utility in this specific patient subgroup remains unclear. This trial aims to determine whether prophylactic administration of indomethacin offers a measurable benefit over no intervention in this lower-risk population.

Eligible patients will be identified prior to their scheduled biliary ERCP and screened for inclusion criteria. Following informed consent, participants will be randomized to receive either rectal indomethacin or no indomethacin prior to the procedure.

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Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 4

Primary location

University of California, San Francisco

San Francisco, California, 94158, United States

Location contact

Abdul Kouanda, MD

SUB_INVESTIGATOR

Michael C Larsen, MD

CONTACT

[email protected]

415-502-4444

Michael C Larsen, MD

PRINCIPAL_INVESTIGATOR

Patrick Avila, MD, MPH

SUB_INVESTIGATOR

Sun-Chuan Dai, MD

SUB_INVESTIGATOR

Vu Dinh, MD, PhD

CONTACT

[email protected]

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Male or female ≥ 18 years of age at the time of ERCP.
  • Scheduled to undergo routine biliary ERCP with documentation of a prior biliary sphincterotomy.
  • Ability to receive rectal medication.
  • Ability and willingness to comply with all study procedures and follow-up requirements.
  • Written informed consent (and assent when applicable) was obtained from the subject or the subject's legal representative, and the subject's ability to comply with the requirements of the study was confirmed.

Exclusion criteria

  • Pregnant, breastfeeding, or unwilling to practice birth control during participation in the study.
  • Known hypersensitivity or contraindication to indomethacin, other nonsteroidal anti-inflammatory drugs, or suppository components.
  • Active gastrointestinal bleeding, history of NSAID-induced gastrointestinal ulceration, or other conditions that contraindicate NSAID use.
  • Significant renal impairment (e.g., baseline serum creatinine above institutional upper limit of normal or estimated glomerular filtration rate < 30 mL/min/1.73 m²).
  • Current use of other NSAIDs that cannot be safely discontinued per the investigator's judgment.
  • Known chronic pancreatitis
  • Presence of a condition or abnormality that, in the opinion of the Investigator, would compromise the safety of the patient or the quality of the data.

Treatment and study plan

Indomethacin

Drug

Indomethacin 100 mg administered as a single rectal suppository immediately prior to biliary ERCP for the prevention of post-ERCP pancreatitis. Participants are randomized to receive the study intervention before the procedure.

Other names: rectal indomethacin

Primary outcomes

  1. Incidence of Post-ERCP Pancreatitis

    Time frame: Within 30 days following ERCP Procedure

    The incidence of post-ERCP pancreatitis (PEP) following biliary ERCP, defined using standard consensus criteria: new or worsened abdominal pain consistent with acute pancreatitis, elevation of serum amylase or lipase to at least three times the upper limit of normal within 24 hours after ERCP, and hospitalization or prolongation of planned admission attributable to pancreatitis. The outcome will be compared between participants receiving prophylactic rectal indomethacin and those receiving placebo.

Secondary outcomes

  1. Severity of Post-ERCP Pancreatitis

    Time frame: Within 30 days of ERCP

    Severity of post-ERCP pancreatitis classified according to standard consensus criteria as mild, moderate, or severe among participants who develop post-ERCP pancreatitis.

  2. Incidence of ERCP-Related Adverse Events

    Time frame: Within 30 days of ERCP Procedure

    Incidence of ERCP-related complications, including bleeding, infection, and perforation, occurring after the ERCP procedure.

  3. Incidence of Indomethacin-Related Adverse Events

    Time frame: Within 30 days of ERCP Procedure

    Incidence of adverse events potentially attributable to indomethacin administration, including gastrointestinal bleeding, renal dysfunction, and allergic or hypersensitivity reactions.

  4. Hospital Admission Following ERCP

    Time frame: Within 30 of ERCP Procedure

    Proportion of participants requiring hospitalization or unplanned admission following ERCP due to post-procedure complications.

Study contacts

Contact information is provided by the study sponsor or research team.

Vu Dinh, MD, PhD

CONTACT

[email protected]

7142249012

Sponsors and collaborators

Lead sponsor

University of California, San Francisco

Other

Registry information

Official study title

Indomethacin vs. no Indomethacin for Patients Undergoing Biliary ERCP With Prior Biliary Sphincterotomy

Important dates

Study start
2026
Primary completion
2031
Study completion
2031
First posted
Jun 22, 2026
Registry last updated
Jun 22, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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