The Prospective Randomized Controlled Study Of Raw Rhubarb Soak Solution In Precaution Post- Endoscopic Retrograde Cholangiopancreatography Pancreatitis In Patients With High-risk Factors

Objectives:To evaluate the efficacy of raw rhubarb soaking solution in preventing post-ERCP pancreatitis(PEP) and hyperamylasemia.Methods:Five hundred cases of high-risk patients were randomly divided into the raw rhubarb group(250 cases) and the control group(250 cases) from October 2012 to October 2013. Postoperative conventional treatment was given in both groups, where the patients in the raw rhubarb group started to take raw rhubarb soaking solution(50g raw rhubarb of the same source soaked in boiled water for 10 min every time)after ERCP surgery(q3h) until purgation. 24-hour blood routine and liver function were detected in both groups after surgery. The postoperative symptoms(such as abdominal pain, abdominal distension, etc.) and purgation time were observed in patients.Results:No significant differences were reported between two groups in terms of demographic characteristics, medical history, ERCP procedures, and patient-related and surgery-related high-risk factors. Among 250 patients taking raw rhubarb, 5(2%)patients developed PEP while 19(7.6%) patients developed PEP among 250 patients in the control group, indicating that the difference between the two groups was statistically significant(P = 0.003). The incidences of post-ERCP hyperamylasemia were 5.2%(13/250) and 16.8%(42/250) in the raw rhubarb group and the control group respectively, and the incidence in the raw rhubarb group was significantly lower than that in the control group(P<0.01). The severe PEP cases in the raw rhubarb group was obviously less than that in the control group without statistical significance(P>0.05). The incidence of postoperative abdominal pain in the raw rhubarb group was also significantly lower than that in the control group(P<0.01),but the difference in the degree of abdominal pain was not statistically significant(P>0.05). No significant differences were reported before ERCP surgery between two groups in terms of leukocytes, serum total bilirubin, alanine aminotransferase levels. the differences in WBC, ALT and TBIL levels were not statistically significant between two groups after surgery(P>0.05).Conclusions:Raw rhubarb can reduce the incidence of PEP and hyperamylasemia in high-risk patients,also can reduce the incidence of postoperative abdominal pain.