Document Detail


Nafamostat mesylate in the prevention of post-ERCP pancreatitis and risk factors for post-ERCP pancreatitis.
MedLine Citation:
PMID:  19327467     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Pancreatitis is a major complication of ERCP. OBJECTIVE: To determine whether nafamostat mesylate prophylaxis decreases the incidence of post-ERCP pancreatitis (PEP). DESIGN: A single-center, randomized, double-blinded, controlled trial. SETTING: A large tertiary-referral center. PATIENTS: From January 2005 to December 2007, a total of 704 patients who underwent ERCP were analyzed. INTERVENTION: Patients received continuous infusion of 500 mL of 5% dextrose solution with 20 mg of nafamostat mesylate (354 patients) or without 20 mg of nafamostat mesylate (350 patients). Serum amylase and lipase levels were checked before ERCP, 4 and 24 hours after ERCP, and when clinically indicated. MAIN OUTCOME MEASUREMENTS: The incidence of PEP and risk factors associated with the development of PEP. RESULTS: The incidence of acute pancreatitis was 5.4%. There was a significant difference in the incidence of PEP between the nafamostat mesylate and control groups (3.3% vs 7.4%, respectively; P = .018). Univariate analysis identified history of acute pancreatitis (P < .001), difficult cannulation (P = .023), periampullary diverticulum (P = .004), age younger than 40 years (P = .009), and >/=5 pancreatic-duct contrast injections (odds ratio [OR] 2.736, P = .012) as statistically significant risk factors. LIMITATIONS: A single-center study. CONCLUSIONS: Nafamostat mesylate prophylaxis is partially effective in preventing post-ERCP pancreatitis. Independent risk factors for PEP are a history of acute pancreatitis and multiple pancreatic-duct contrast injections.
Authors:
Cheol Woong Choi; Dae Hwan Kang; Gwang Ha Kim; Jae Sup Eum; Sun Mi Lee; Geun Am Song; Dong Uk Kim; Il Doo Kim; Mong Cho
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Gastrointestinal endoscopy     Volume:  69     ISSN:  1097-6779     ISO Abbreviation:  Gastrointest. Endosc.     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-03-30     Completed Date:  2009-07-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0010505     Medline TA:  Gastrointest Endosc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e11-8     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.
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MeSH Terms
Descriptor/Qualifier:
Aged
Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
Cholangiopancreatography, Endoscopic Retrograde / adverse effects*
Double-Blind Method
Female
Guanidines / therapeutic use*
Humans
Male
Middle Aged
Pancreatitis / etiology*,  prevention & control*
Prospective Studies
Risk Factors
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents, Non-Steroidal; 0/Guanidines; 81525-10-2/nafamostat

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