Document Detail


Transdermal glyceryl trinitrate for prevention of post-ERCP pancreatitis: A randomized double-blind trial.
MedLine Citation:
PMID:  12518122     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Pancreatic sphincter hypertension increases the risk of pancreatitis in patients undergoing ERCP. Glyceryl trinitrate reduces sphincter of Oddi pressure. This study tested the hypothesis that transdermal glyceryl trinitrate could be effective in the prevention of post-ERCP pancreatitis. METHODS: One hundred forty-four patients undergoing ERCP were randomized: 71 received a 15-mg glyceryl trinitrate patch (glyceryl trinitrate group) and 73 a placebo patch (control group). RESULTS: In the control group, post-ERCP pancreatitis developed in 11 patients versus 3 in the glyceryl trinitrate group (p < 0.05). Twenty-four hour to baseline serum amylase and lipase ratios were lower in the glyceryl trinitrate group (respectively, 3.6 vs. 7.5, p < 0.05; and 5.3 vs. 27.7, p < 0.05). In a multivariate analysis, glyceryl trinitrate patch and the number of pancreatic injections, but not endoscopic sphincterotomy, were independent risk factors for post-ERCP pancreatitis. CONCLUSIONS: The results of this study suggest that use of a transdermal glyceryl trinitrate patch protects against post-ERCP pancreatitis.
Authors:
Manuel Moretó; Manuel Zaballa; Ignacio Casado; Olga Merino; Miguel Rueda; Kléber Ramírez; Raquel Urcelay; Amaia Baranda
Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Gastrointestinal endoscopy     Volume:  57     ISSN:  0016-5107     ISO Abbreviation:  Gastrointest. Endosc.     Publication Date:  2003 Jan 
Date Detail:
Created Date:  2003-01-08     Completed Date:  2003-04-22     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0010505     Medline TA:  Gastrointest Endosc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1-7     Citation Subset:  IM    
Affiliation:
Servicio de Gastroenterología, Hospital de Cruces, Barakaldo, Spain.
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MeSH Terms
Descriptor/Qualifier:
Administration, Cutaneous
Aged
Amylases / blood
Cholangiopancreatography, Endoscopic Retrograde / adverse effects*,  methods
Double-Blind Method
Endpoint Determination
Female
Humans
Lipase / blood
Male
Multivariate Analysis
Nitroglycerin / therapeutic use*
Pancreatitis / blood,  etiology,  prevention & control*
Postoperative Complications
Risk Factors
Sphincter of Oddi / drug effects
Treatment Outcome
Vasodilator Agents / administration & dosage*,  adverse effects,  therapeutic use*
Chemical
Reg. No./Substance:
0/Vasodilator Agents; 55-63-0/Nitroglycerin; EC 3.1.1.3/Lipase; EC 3.2.1.-/Amylases
Comments/Corrections
Comment In:
Gastrointest Endosc. 2003 Dec;58(6):940; author reply 940-1   [PMID:  14682304 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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