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

作　　者：Hector Martinez-Torres Xochilt Rodriguez-Lomeli Carlo Davalos-Cobian Jesus Garcia-Correa Juan Manue Maldonado-Martinez Fabiola Medrano-Muoz Clotilde Fuentes-Orozco Alejandr Gonzalez-Ojeda 

机构地区：[1]Department of Gastroenterology an Endoscopy,UMAE-Hospital de Especialidades del Centr Medico Nacional de Occidente-IMSS [2]Research Unit in Clinical Epidemiology UMAE-Hospital de Especialidades del Centro Medico Naciona de Occidente-IMSS

出　　处：《World Journal of Gastroenterology》2009年第13期1600-1606,共7页世界胃肠病学杂志（英文版）

基　　金：Supported by Economic resources of the Department of Gastroenterology and Endoscopy;the Research Unit in Clinical Epidemiology

摘　　要：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 times.Main Outcome Measurements included serum amylase levels and the number severity of the episodes of pancreatitis.Serum amylase levels were classified as normal(<150 IU/L)or hyperamylasemia(>151 IU/L).Episodes of PEP were classified following Ranson's criteria and CT severity index.RESULTS:Gender distribution was similar between groups.Mean age was 53.5±18.9 years for study group and 52.8±19.8 years for controls.Also,the distribution of benign pathology was similar between groups.Hyperamylasemia 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 effects.CONCLUSION:Oral allopurinol before ERCP decreased the incidences of hyperamylasemia and pancreatitis in patients submitted to high-risk procedures.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 times. Main Outcome Measurements included serum amylase levels and the number severity of the episodes of pancreatitis. Serum amylase levels were classified as normal （〈 150 IU/L） or hyperamylasemia （〉 151 IU/L）. Episodes of PEP were classified following Ranson＇s criteria and CT severity index.RESULTS： Gender distribution was similar between groups. Mean age was 53.5 ±18.9 years for study group and 52.8 ± 19.8 years for controls. Also, the distribution of benign pathology was similar between groups. Hyperamylasemia 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 effects.CONCLUSION： 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 

分 类 号：R576[医药卫生—消化系统]