Pretreatment with allopurinol diminishes pancreatography-induced pancreatitis in a canine model.
BACKGROUND
The role of oxygen-derived free radicals in the pathogenesis of pancreatitis has been supported by data from previous studies using animal models. This study was conducted to determine whether prophylaxis with the xanthine oxidase inhibitor allopurinol would decrease the incidence and severity of pancreatography-induced pancreatitis in a canine model.


METHODS
Thirty-two dogs were randomized to receive either placebo or oral allopurinol 1 hour before the procedure. A laparotomy and duodenotomy were performed and a pancreatogram was obtained. Postoperatively, pancreatic enzymes were drawn for 5 days. The animals were then euthanized, and the pancreas was weighed and evaluated histologically.


RESULTS
The histologic incidence of pancreatitis was significantly reduced in the allopurinol pretreatment group (6.7%) as compared with the placebo group (41.2%, p < 0.01). A significant decrease in postoperative serum amylase levels among dogs pretreated with allopurinol was also noted. A similar trend was observed in lipase levels. The pancreas weight index was decreased in the allopurinol pretreatment group as well (control = 0.00246 vs. allopurinol = 0.00195, p < 0.02).


CONCLUSIONS
Pretreatment with oral allopurinol decreases the incidence of pancreatography-induced pancreatitis. These results support the role of xanthine oxidase inhibitors in the prevention of endoscopic retrograde cholangiopancreatography-induced pancreatitis.
Department of Surgery and Pathology, Mount Sinai Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio 44106, USA.
J M
JM
Marks
B J
BJ
Dunkin
B L
BL
Shillingstad
D F
DF
Youngelman
M A
MA
Schweitzer
R H
RH
Lash
J
J
Singh
L
L
Ponsky
J L
JL
Ponsky
D000493:Allopurinol / Q000627:therapeutic use*; D000818:Animals; D004195:Disease Models, Animal; D004285:Dogs; D004353:Drug Evaluation, Preclinical; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D010179:Pancreas / Q000000981:diagnostic imaging* / Q000187:drug effects / Q000201:enzymology / Q000473:pathology; D010195:Pancreatitis / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D011292:Premedication / Q000379:methods*; D011859:Radiography; D011897:Random Allocation; D013997:Time Factors; D014969:Xanthine Oxidase / Q000037:antagonists & inhibitors*
D004791:Enzyme Inhibitors; D000493:Allopurinol; D014969:Xanthine Oxidase