Korean Journal of Gastrointestinal Endoscopy 2000;21(1): 534-542.
내시경적 역행성 담췌관조영술과 관련된 췌손상 예방에 대한 Gabexate Mesilate의 효과 ( Effects of Gabexate Mesilate for the Prevention of Pancreatic Damage Related to ERCP )
진윤태(Yoon Tae Jeen),전훈재(Hoon Jai Chun),이정환(Jung Whan Lee),허병원(Byung Won Hur),이홍식(Hong Sik Lee),송치욱(Chi Wook Song),엄순호(Soon Ho Um),이상우(Sang Woo Lee),최재현(Jae Hyun Choi),김창덕(Chang Duk Kim),류호상(Ho Sang Ryu),현진해(Jin Hai Hyun),강창돈(Chang Don Kang)
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. Method : 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. (Korean J Gastrointest Endosc 2000;21:534-542)
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