Effects of Gabexate Mesilate for the Prevention of Pancreatic Damage Related to ERCP.
- Author:
Yoon Tae JEEN
1
;
Hoon Jai CHUN
;
Jung Whan LEE
;
Byung Won HUR
;
Hong Sik LEE
;
Chi Wook SONG
;
Soon Ho UM
;
Sang Woo LEE
;
Jae Hyun CHOI
;
Chang Duk KIM
;
Ho Sang RYU
;
Jin Hai HYUN
;
Chang Don KANG
Author Information
1. Departments of Internal Medicine, Institute of Digestive Disease and Nutrition, Korea University College of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
ERCP;
Gabexate mesilate;
Hyperenzymemia;
Pancreatitis
- MeSH:
Amylases;
Catheterization;
Cholangiopancreatography, Endoscopic Retrograde*;
Cost-Benefit Analysis;
Gabexate*;
Humans;
Incidence;
Lipase;
Pancreatic Ducts;
Pancreatitis;
Prospective Studies
- From:Korean Journal of Gastrointestinal Endoscopy
2000;21(1):534-542
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: Recent studies reported that 1g of gabexate mesilate (GM) was effective in preventing endoscopic retrograde cholangiopancreatography (ERCP)-related pancreatic damage. The aim of this study was to evaluate the effectiveness of low dose GM for the prevention of ERCP-related pancreatic damage. METHODS: This study was performed prospectively with 102 consecutive patients (68 for the GM group, 34 for the placebo group) who were scheduled for ERCP. Infusion of GM (500 mg) was started 30 minutes before ERCP and continued for 12 hours afterward. The serum amylase and lipase were measured before ERCP and 4, 8, and 24 houps after ERCP. RESULTS: The incidence of hyperenzymemia was 45.6% in the GM group and 55.9% in the control group (p=0.40). Acute pancreatitis was developed in only one patient who was given the placebo. Although difficult cannulation, visualization of the pancreatic duct, performance of therapeutic procedures, and longer total procedure time were associated with an increased incidence of hyperenzymemia, the incidence of pancreatic damage was not affected by the GM treatment in these conditions. CONCLUSIONS: Prophylactic treatment with 500 mg of GM has no advantage for the prevention of ERCP-related pancreatic damage. Considering the cost effectiveness, further studies are necessary to identify the patients at greatest risk fot acute pancreatitis.
