Natural beta-carotene for the prevention of post-ERCP pancreatitis.
OBJECTIVE
Endoscopic retrograde cholangiopancreatography (ERCP) is a commonly used procedure. Pancreatitis is its most common complication. As the injury may be mediated by oxidative stress, it could be ameliorated by antioxidants.


METHODS
We conducted a double-blind trial, giving the patients a single dose of natural beta-carotene or placebo, 12 hours prior to procedure, and monitoring them for 24 hours post-procedure for procedure complications, antioxidant levels, and plasma oxidation.


RESULTS
The overall incidence of acute pancreatitis according to our definition was 9.6%. The incidence of pancreatitis was not significantly different between the beta-carotene group (10%) and the placebo group (9.4%). Four patients in the placebo group had severe pancreatitis (2.22%), but none in the beta-carotene group. This difference is statistically significant.


CONCLUSIONS
We did not see a reduction in the incidence of post-ERCP pancreatitis, but there may be some protective effect of treatment with beta-carotene regarding the severity of disease.
Lavy
A
A
Gastroenterology Unit, Bnai-Zion Medical Center, Haifa, Israel. lavya@netvision.net.il
Karban
A
A
Suissa
A
A
Yassin
K
K
Hermesh
I
I
Ben-Amotz
A
A
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000681:Amylases / Q000097:blood; D000975:Antioxidants / Q000008:administration & dosage / Q000627:therapeutic use*; D015415:Biomarkers; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D015994:Incidence; D007902:Length of Stay / Q000706:statistics & numerical data; D015227:Lipid Peroxidation / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress; D010195:Pancreatitis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D010587:Phagocytosis; D011292:Premedication; D012307:Risk Factors; D012720:Severity of Illness Index; D017211:Treatment Failure; D014801:Vitamin A / Q000097:blood; D014810:Vitamin E / Q000097:blood; D019207:beta Carotene / Q000008:administration & dosage / Q000627:therapeutic use*
D000975:Antioxidants; D015415:Biomarkers; D019207:beta Carotene; D014801:Vitamin A; D014810:Vitamin E; D000681:Amylases