Nafamostat for Prophylaxis against Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis Compared with Gabexate.
- Author:
Jae Hyuck CHANG
1
;
In Seok LEE
;
Hyung Keun KIM
;
Yu Kyung CHO
;
Jae Myung PARK
;
Sang Woo KIM
;
Myung Gyu CHOI
;
In Sik CHUNG
Author Information
1. Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. isle@catholic.ac.kr
- Publication Type:In Vitro ; Original Article
- Keywords:
Gabexate;
Nafamostat;
Endoscopic retrograde cholangiopancreatography;
Pancreatitis;
Hyperamylasemia
- MeSH:
Amylases;
Cholangiopancreatography, Endoscopic Retrograde;
Gabexate;
Guanidines;
Humans;
Hyperamylasemia;
Incidence;
Pancreatitis;
Protease Inhibitors;
Retrospective Studies
- From:Gut and Liver
2009;3(3):205-210
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: The protease inhibitors, nafamostat and gabexate, have been used to prevent pancreatitis related to endoscopic retrograde cholangiopancreatography (ERCP). In vitro, nafamostat inhibits the pancreatic protease activities 10-100 times more potently than gabexate. We evaluated the efficacy of nafamostat for prophylaxis against post-ERCP pancreatitis in comparison with gabexate. METHODS: Five hundred patients (208 patients in the nafamostat-treated group and 292 in the gabexate-treated group) were analyzed retrospectively after selective exclusion. The incidences of pancreatitis and hyperamylasemia after the ERCP were compared between the nafamostat and gabexate groups. RESULTS: The incidences of acute pancreatitis and hyperamylasemia were 9.1% and 40.9%, respectively, in the nafamostat-treated group, and 8.6% and 39.4% in the gabexate-treated group. The frequencies of post-ERCP pancreatitis and hyperamylasemia did not differ significantly between the two groups, Post-ERCP pancreatitis in two group did not vary according to the different ERCP procedures. The mean serum amylase level at 6 h after ERCP was significantly lower in the nafamostat-treated group than in the gabexate-treated group (p=0.020). However, the difference in serum amylase level did not persist at 18 h and 36 h post-ERCP. CONCLUSIONS: Administration of nafamostat before ERCP was not inferior to gabexate in protecting against the development of pancreatitis.
