| Nafamostat mesylate in the prevention of post-ERCP pancreatitis and risk factors for post-ERCP pancreatitis. | |
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MedLine Citation:
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PMID: 19327467 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: Gastrointestinal endoscopy Volume: 69 ISSN: 1097-6779 ISO Abbreviation: Gastrointest. Endosc. Publication Date: 2009 Apr |
Date Detail:
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Created Date: 2009-03-30 Completed Date: 2009-07-15 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0010505 Medline TA: Gastrointest Endosc Country: United States |
Other Details:
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Languages: eng Pagination: e11-8 Citation Subset: IM |
Affiliation:
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Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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0/Anti-Inflammatory Agents, Non-Steroidal; 0/Guanidines; 81525-10-2/nafamostat |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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