Gadolinium as an alternative contrast agent for therapeutic ERCP in the iodine-allergic patient.
Performance of endoscopic retrograde cholangiopancreatography (ERCP) requires an intraductal contrast agent. The contrast of choice is an iodine-based agent. The alternatives in patients with a severe allergy to iodinated contrast are limited. We undertook a retrospective review of the success and safety of gadolinium as an alternative radiocontrast agent in patients with allergy to iodine-based contrast in a series of five patients in a tertiary care pancreaticobiliary referral center. The five patients underwent a total of six ERCP procedures using a gadolinium chelate as the radiocontrast agent. ERCP was technically successful in all cases, including pancreatic endotherapy. There were no contrast-related adverse reactions. Gadolinium is concluded to be a reasonable alternative to iodine-based ERCP contrast in selected patients. It provides inferior image quality compared to standard iodine-based contrast but was not technically limiting in our small experience.
Lawrence
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Medical University of South Carolina, Charleston, South Carolina 29425-2900, USA. Lawrench@musc.edu
Cotton
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D000328:Adult; D000368:Aged; D002760:Cholangiopancreatography, Endoscopic Retrograde; D003287:Contrast Media / Q000009:adverse effects*; D005260:Female; D005682:Gadolinium; D006801:Humans; D007455:Iodine / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged
D003287:Contrast Media; D007455:Iodine; D005682:Gadolinium