A randomized controlled trial of pentoxifylline for the prevention of post-ERCP pancreatitis.
BACKGROUND
Pentoxifylline can ameliorate pancreatitis in animal models because of its anti-tumor necrosis factor properties.


OBJECTIVE
Our purpose was to study the safety and efficacy of pentoxifylline in the prevention of post-ERCP pancreatitis.


METHODS
Patients due to undergo ERCP for various indications were randomized to receive pentoxifylline 400 mg orally 3 times, beginning the day before ERCP (2 and 10 pm) until the night after the procedure (6 am and 2 and 10 pm) or to receive no preventive medication. Serum amylase values were determined before and 6 and 24 hours after ERCP. Diagnosis and grading of the severity of complications was performed according to consensus criteria.


METHODS
One hundred fifty-eight patients received pentoxifylline (group A) and 162 had no medication (group B). The groups were similar in distributions of sex, biliary sphincterotomy, pancreatography, pancreatic duct cannulations, stone extraction, stent placement, and presence of periampullary diverticulum. Group A patients were younger (mean age 63 vs 68 years, P<.05) and biliary colic was a more frequent indication (30 vs 12, P<.05).


RESULTS
Nine (5.6%) patients in group A and 5 (3%) in group B had pancreatitis (2 and 1 severe, respectively; P=.28). Serum amylase values were similar in baseline and 6- and 24-hour samples. Two (1.2%) patients in group A and 7 (4.3%) in group B had hemorrhage.


CONCLUSIONS
This was not a double-blind trial.


CONCLUSIONS
In this study pentoxifylline did not protect against post-ERCP pancreatitis or hyperamylasemia.
Kapetanos
Dimitrios
D
Gastroenterology Department, George Papanikolaou Hospital, Thessaloniki, and First Division of Internal Medicine, Gastroenterology Unit, Medical School, University of Ioannina, Ioannina, Greece.
Kokozidis
Georgios
G
Christodoulou
Dimitrios
D
Mistakidis
Konstantinos
K
Sigounas
Dimitrios
D
Dimakopoulos
Konstantinos
K
Kitis
Georgios
G
Tsianos
Epaminondas V
EV
D000368:Aged; D001649:Bile Duct Diseases / Q000175:diagnosis / Q000628:therapy*; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects*; D005260:Female; D006801:Humans; D034321:Hyperamylasemia / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000517:prevention & control*; D010431:Pentoxifylline / Q000627:therapeutic use*; D011292:Premedication; D016717:Sphincterotomy, Endoscopic / Q000009:adverse effects
D010431:Pentoxifylline