Document Detail


A comparative study of contrast agents for endoscopic retrograde pancreatography.
MedLine Citation:
PMID:  1928034     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Pancreatitis is a major cause of morbidity and mortality secondary to endoscopic retrograde pancreatography (ERP). One factor that may cause post-ERP pancreatitis is the type of contrast media utilized during the procedure. The purpose of this prospective, double-blind, randomized study was to evaluate the effects of three contrast agents of differing osmolality and ionicity on changes between pre- and post-ERP chemical changes in serum amylase and lipase and development of clinical symptoms of acute pancreatitis. Our study of 53 patients showed that those who received Omnipaque a non-ionic, relatively iso-osmolar contrast agent, had a significantly lower serum amylase (p = 0.0038) and serum lipase (p = 0.0002) in post-ERP serological markers, compared with patients who received the ionic agents, Hypaque meglumine 60% or Hexabrix. In addition, the development of clinical symptoms of pancreatitis was less in patients who received Omnipaque than in those who received Hexabrix or Hypaque (1 vs. 3 vs. 4). No significant difference was found between patients who received ionic agents. No patient who received Omnipaque needed hospitalization, whereas one (6%) patient who received Hexabrix was hospitalized compared to three (20%) hospitalized patients who received Hypaque. When the initial cost and cost of hospitalization were compared, the non-ionic contrast medium was also found to be more cost-effective for the patient. In summary, the risk of post-ERP acute pancreatitis was significantly lower for patients who received the non-ionic contrast agent than for those who received the ionic agents.
Authors:
J S Barkin; G L Casal; D K Reiner; R I Goldberg; R S Phillips; S Kaplan
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  The American journal of gastroenterology     Volume:  86     ISSN:  0002-9270     ISO Abbreviation:  Am. J. Gastroenterol.     Publication Date:  1991 Oct 
Date Detail:
Created Date:  1991-10-28     Completed Date:  1991-10-28     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0421030     Medline TA:  Am J Gastroenterol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1437-41     Citation Subset:  IM    
Affiliation:
Division of Gastroenterology, University of Miami, School of Medicine/Mt. Sinai Medical Center, Florida.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Cholangiopancreatography, Endoscopic Retrograde / adverse effects,  methods*
Diatrizoate Meglumine / diagnostic use*
Double-Blind Method
Female
Humans
Iohexol / diagnostic use*
Ioxaglic Acid / diagnostic use*
Male
Middle Aged
Osmolar Concentration
Pancreatitis / etiology
Chemical
Reg. No./Substance:
131-49-7/Diatrizoate Meglumine; 59017-64-0/Ioxaglic Acid; 66108-95-0/Iohexol
Comments/Corrections
Comment In:
Am J Gastroenterol. 1992 May;87(5):682-3; author reply 684-5   [PMID:  1595669 ]
Am J Gastroenterol. 1992 May;87(5):683-4; author reply 684-5   [PMID:  1595671 ]
Am J Gastroenterol. 1992 May;87(5):683; author reply 684-5   [PMID:  1595670 ]

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


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