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Oral allopurinol to prevent hyperamylasemia and acute pancreatitis after endoscopic retrograde cholangiopancreatography

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World Journal of Gastroenterology 2009年第13期15卷 1600-1606页

作者： Hector Martinez-Torres Xochilt Rodriguez-Lomeli Carlo Davalos-Cobian Jesus garcia-Correa Juan Manue Maldonado-Martinez Fabiola Medrano-Muoz Clotilde Fuentes-Orozco alejandr.Gonzalez-Ojeda Department of Gastroenterology an Endoscopy UMAE-Hospital de Especialidades del Centr Medico Nacional de Occidente-IMSS Research Unit in Clinical Epidemiology UMAE-Hospital de Especialidades del Centro Medico Naciona de Occidente-IMSS

AIM:To assess the efficacy of allopurinol to prevent hyperamylasemia and pancreatitis after endoscopic retrograde cholangiopancreatography(PEP).METHODS:One hundred and seventy patients were enrolled and randomized to two groups:a study group(n=85)who received 300 mg of oral allopurinol at 15 h and 3 h before endoscopic retrograde cholangiopancreatography(ERCP)and a control group(n=85)receiving an oral placebo at the same *** Outcome Measurements included serum amylase levels and the number severity of the episodes of *** amylase levels were classified as normal(151 IU/L).Episodes of PEP were classified following Ranson's criteria and CT severity ***:Gender distribution was similar between *** age was 53.5±18.9 years for study group and 52.8±19.8 years for ***,the distribution of benign pathology was similar between *** was more common in the control group(P=0.003).Mild PEP developed in two patients from the study group(2.3%)and eight(9.4%) from control group(P=0.04),seven episodes were observed in high-risk patients of the control group(25%) and one in the allopurinol group(3.3%,P=0.02).Risk factors for PEP were precut sphincterotomy(P=0.02),pancreatic duct manipulation(P=0.002)and multiple procedures(P=0.000).There were no deaths or side ***:Oral allopurinol before ERCP decreased the incidences of hyperamylasemia and pancreatitis in patients submitted to high-risk procedures.

关键词： Endoscopic retrograde cholangiopancreatography Hyperamylasemia Acute pancreatitis Oralallopurinol Risk factors

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