title: Comparison between ulinastatin and gabexate mesylate for the prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis: a prospective, randomized trial.
abstract: BACKGROUND
  It has been reported that the administration of ulinastatin, gabexate mesylate, or somatostatin may be effective in the prevention of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis. However, few randomized trials of ulinastatin and gabexate mesylate for the prevention of post-ERCP pancreatitis have been reported. The aim of this study was to compare the efficacy of ulinastatin and gabexate mesylate for the prevention of post-ERCP pancreatitis.
  
  
  METHODS
  Sixty-eight patients who underwent diagnostic ERCP at our hospital were divided at random by computer-generated randomization into an ulinastatin group (n = 34) and a gabexate group (n = 34). Each patient received a continuous intravenous infusion of ulinastatin (150,000 units) or gabexate mesylate (600 mg), beginning 60-90 min before the ERCP and continuing until 22 h after the ERCP. The primary endpoint was the incidence of post-ERCP pancreatitis, and the secondary endpoints were the incidences of hyperenzymemia and pain.
  
  
  RESULTS
  The overall incidence of post-ERCP pancreatitis was 2.9% (two patients), comprising one patient in the ulinastatin group and one patient in the gabexate group (2.9% vs 2.9%, respectively). Neither of these two patients developed severe pancreatitis. There were no significant differences in the serum levels of pancreatic enzymes or in the levels of pain between the two groups.
  
  
  CONCLUSIONS
  There was no clinical difference between the effect of preventive administration of ulinastatin and that of gabexate mesylate on the incidence of post-ERCP pancreatitis. Ulinastatin may be equivalent in efficacy to gabexate for reducing the incidence of post-ERCP pancreatitis.
authors.affiliation: Department of Gastroenterology, Chikushi Hospital, Fukuoka University, 1-1-1 Zokumyoin, Chikushino-Shi, Fukuoka, Japan.
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Ueki
authors.forename: Keisuke
authors.initials: K
authors.lastname: Otani
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Kawamoto
authors.forename: Aiko
authors.initials: A
authors.lastname: Shimizu
authors.forename: Naruhito
authors.initials: N
authors.lastname: Fujimura
authors.forename: Seigo
authors.initials: S
authors.lastname: Sakaguchi
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Matsui
mesh_terms: D000368:Aged; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects*; D005260:Female; D016670:Gabexate / Q000627:therapeutic use*; D006023:Glycoproteins / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000209:etiology* / Q000517:prevention & control*; D011446:Prospective Studies
chemical_list: D006023:Glycoproteins; D016670:Gabexate; C028665:urinastatin