metrizamide and Pancreatitis

Endoscopic retrograde pancreatography (ERP) with parenchymatous contrast filling may result in clinical pancreatitis. The aim of the present prospective trial was to assess the frequency of acute pancreatitis after pancreatic parenchymatography with a non-ionic contrast medium, metrizamide. For ethical reasons the examination was designed as a sequential study with clearly defined stopping rules. None of the 48 patients studied developed clinical pancreatitis. This indicates that the probability of pancreatitis after parenchymatography is less than 5%. A high degree of contrast filling was obtained both in patients with normal and in those with pathologic pancreatic ducts. The contrast filling of the ducts was associated with not more than a slight pain. The rise in serum amylase was considerable but was not associated with clinical pancreatitis and returned to preexamination levels within 48 h. The examination shows that the non-ionic contrast medium used is well tolerated in ERP.

Topics: Adult; Aged; Cholangiopancreatography, Endoscopic Retrograde; Clinical Trials as Topic; Female; Humans; Male; Metrizamide; Middle Aged; Pancreatitis; Prospective Studies; Risk

Endoscopic retrograde cholangio-pancreatography (ERCP) has been performed in 17 patients using metrizamide (Amipaque) as contrast medium, and in 33 using meglumine diatrizoate (Urografin). The quality of pancreatograms obtained has been compared, using a specially developed scoring system, an any clinical and biochemical evidence of (acute) pancreatitis following ERCP observed. The mean pancreatogram score was slightly higher when Amipaque was used but there was no difference in the frequency or extent of hyperamylasaemia between the two groups. The slight advantage of Amipaque is not sufficient to overcome the disadvantages of its relatively high cost and inconvenience in use.

Topics: Cholangiopancreatography, Endoscopic Retrograde; Clinical Trials as Topic; Diatrizoate Meglumine; Double-Blind Method; Humans; Metrizamide; Middle Aged; Pancreatitis; Random Allocation

Endoscopic retrograde pancreatography (ERP) may be followed by elevated serum amylase or occasionally by pancreatitis. This is said to be due to the irritating effect of contrast media (CM) or to the cation content of CM. We investigated the effect of intraductally injected CM (ionic CM with and without sodium, non-ionic CM) on the porcine pancreas. All types of CM as well as control media (saline, 7% sodium bicarbonate solution) produced small foci of histological pancreatitis, although without any clinical signs of pancreatitis.

Topics: Animals; Cholangiopancreatography, Endoscopic Retrograde; Contrast Media; Diatrizoate Meglumine; Metrizamide; Pancreas; Pancreatitis; Swine

An analysis of endoscopic retrograde cholangiopancreatography (ERCP) examinations suggests that repeated contrast injection into the pancreatic duct during attempts to cannulate the bile duct is of major importance in the aetiology of acute pancreatitis after ERCP, even in the absence of pancreatic acinar opacification. The technique of ERCP can easily be modified to avoid repeated pancreatic duct injection and, by doing so, an increase in the incidence of acute pancreatitis has been reversed.

Topics: Acute Disease; Bile Ducts; Catheterization; Cholangiopancreatography, Endoscopic Retrograde; Diatrizoate; Diatrizoate Meglumine; Humans; Metrizamide; Pancreatic Ducts; Pancreatitis