Objective To investigate the preventive effect of diclofenac at different doses on post‐ERCP pancreatitis and hyperamylasemia . Methods A total of 244 patients with choledocholithiasis from January 2013 to June 2015 were enrolled to receive ERCP and randomly divided into four groups to receive low dose diclofenac group (50 mg ,n=61) ,moderate dose diclofenac group (100 mg ,n=61) ,high dose diclofenac group (150 mg ,n=61) or no diclofenac ,at half an hour to one hour ,before ERCP . The level of serum amylase before and 3 h or 24 h after ERCP were measured ,Incidence of post‐ERCP pancreatitis and hyperamylasemia were assessed in four groups . Results There were no significant differences among four groups in age ,gender ,surgery method and time of ERCP . The incidences of post‐ERCP pancreatitis were 16 .4% (10/61) ,6 .6% (4/61) and 4 .9% (3/61) ,and 18% (11/61)in diclofenac dose groups and in blank group respectively . The total incidences of post‐ERCP pancreatitis in four groups were significant‐ly different (χ2 =8 .07 , P=0 .045) . There was no significant difference either between low dose group and blank group (χ2 = 0 .058 , P= 0 .810 ) , or between moderate dose group and high dose group (χ2 =0 .152 ,P=0 .697) . There was significant difference between low dose group and high dose group (χ2 =4 .219 ,P=0 .040) . The incidences of hyperamylasemia had no significant difference among four groups (χ2 =2 .83 ,P=0 .419) . There was one case of severe PEP in blank group ,while none in experi‐mental groups . Three moderat PEP was observed in blank group and two in low dose group . The PEP that was observed in moderate and high dose groups were mild . Conclusion The prevention of PEP may not be achieved with diclofenac suppository at 50 mg ,however at 100 mg or 150 mg ,diclofenac supposito‐ry can have preventive effect on post‐ERCP pancreatitis and the effect is similar for the two doses . Therefore ,we recommend that 100 mg diclofenac suppository should be used for preventing PEP .%目的：探讨不同剂量双氯芬酸钠对内镜逆行胰胆管造影术（ERCP）术后胰腺炎（PEP）及高淀粉酶血症的预防效果。方法收集行ERCP取石术的患者244例，随机分为4组，每组61例，其中低剂量组、中剂量组、高剂量组于术前30～60 min分别予双氯芬酸钠栓剂50，100，150 mg塞肛，空白组术前未予处理，观察其术前及术后3，24 h血清淀粉酶水平，评估ERCP术后PEP及高淀粉酶血症发生率及严重程度。结果4组在年龄、性别、ERCP手术方式及操作时间等方面差别均无统计学意义。PEP发生率低剂量组为16．4％（10／61），中剂量组为6．6％（4／61），高剂量组为4．9％（3／61），空白组为18％（11／61），4组术后 PEP总体发病率差别有统计学意义（χ2＝8．07，P＝0．045），其中，空白组与低剂量组、中剂量组与高剂量组比较差别均无统计学意义（χ2＝0．058， P＝0．810；χ2＝0．152，P＝0．697），而低剂量组与高剂量组比较差别有统计学意义（χ2＝4．219，P＝0．040）。术后高淀粉酶血症总体发病率差别无统计学意义（χ2＝2．83，P＝0．419）。空白组发生重度PEP 1例，各实验组均未发生；空白组发生中度PEP 3例，低剂量组发生2例；中、高剂量组发生的PEP均为轻度。结论50 mg双氯芬酸钠栓剂未能有效预防PEP的发生，100及150 mg双氯芬酸钠栓剂均能有效降低PEP的发生率，且效果相当，故推荐使用100 mg双氯芬酸钠栓剂预防PEP发生。
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