Abstract:Objective To observe the preventive effect of epinephrine on pancreatitis after endoscopic retrograde cholangiopancreatography (post-ERCP) in patients with high risk factors. Methods A total of 137 patients with high-risk factors of post-ERCP pancreatitis receiving ERCP were randomly divided into three groups:50 patients treated with 0.01% epinephrine spraying on papilla (group A);44 patients with 100 mg indomethacin suppository for anal insertion(group B);45 patients with 0.01% adrenaline spraying papilla combined with indomethacin suppository for anal insertion (group C).Prospective comparative analysis of the occurrence and severity of post-ERCP pancreatitis was made,and intraoperative condition,postoperative hyperamylasemia and incidence of pancreatitis were recorded in detail among three groups. Results There were no significant differences in cases of pancreatitis (2 vs 3 vs 0,P>0.05) and incidence of hyperamylasemia (44.00% vs 47.73% vs 41.86%，P>0.05) among A-,B- and C-group.The serum amylase level 3-hour after ERCP decreased statistically in the order of A-,B- and C-group (P<0.05). Conclusion Epinephrine spraying on the duodenal papilla can prevent post-ERCP pancreatitis,and its incidence can be reduced by combining indomethacin suppository for anal insertion during ERCP in the patients with high-risk factors.