Comparing rectal indomethacin and intravenous ketorolac for preventing pancreatitis after ERCP

Post ERCP Pancreatitis Prophylaxis, Effectiveness of Rectal Indomethacin vs Intravenous Ketorolac in the Pediatric Population

Phase 4 Interventional Children's Hospital Medical Center, Cincinnati · NCT05664074

This study is testing whether a rectal medication or an intravenous one can better prevent pancreatitis in kids and young adults after a specific procedure called ERCP.

Quick facts

PhasePhase 4
Study typeInterventional
Enrollment192 (estimated)
Ages6 Months to 21 Years
SexAll
SponsorChildren's Hospital Medical Center, Cincinnati Academic / other
Locations1 site (Cincinnati, Ohio)
Trial IDNCT05664074 on ClinicalTrials.gov

What this trial studies

This clinical trial aims to compare the effectiveness of rectal indomethacin versus intravenous ketorolac in preventing post-ERCP acute pancreatitis in pediatric patients aged 6 months to 21 years. Participants scheduled for an ERCP procedure will be randomly assigned to receive one of the two medications to assess which is more effective at reducing the incidence of pancreatitis following the procedure. The study focuses on a population that has not been previously studied in this context, making it a novel approach to addressing a significant complication of ERCP.

Who should consider this trial

Good fit: Ideal candidates for this study are pediatric patients aged 6 months to 21 years who are scheduled to undergo an ERCP.

Not a fit: Patients who are under 10 kg, have a history of biliary sphincterotomy, or have certain medical conditions such as acute pancreatitis or gastrointestinal bleeding may not benefit from this study.

Why it matters

Potential benefit: If successful, this study could provide a more effective medication option for preventing pancreatitis in children undergoing ERCP.

How similar studies have performed: There have been no prior studies comparing the effectiveness of rectal indomethacin and intravenous ketorolac specifically for preventing post-ERCP pancreatitis in pediatric patients, making this a novel investigation.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

* Any patient undergoing ERCP (diagnostic or therapeutic with cannulation of the major or minor papilla)
* Age 6 month- 21 years old
* Does not meet exclusion criteria

Exclusion Criteria:

* \< 10 kg
* Low risk subgroup: Biliary indication with history of prior biliary sphincterotomy.
* High risk for bleeding (Example: Planned liver biopsy)
* Gastrointestinal bleeding in previous 3 days
* Acute pancreatitis (within 3 days) at the time of ERCP
* Use of NSAIDs in the previous 5 days
* Peptic ulcer disease
* Acute kidney Injury or Known Chronic Kidney Disease per KDIGO
* Pregnancy (Pregnancy tests are administered prior to ERCP as standard of care)
* Lithium therapy
* Allergy to ketorolac or indomethacin
* Organ Dysfunction or SIRS

Where this trial is running

Cincinnati, Ohio

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions Post-ERCP Acute Pancreatitis
Last reviewed 2026-06-13 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.