title: Comparison of ionic, monomer, high osmolar contrast media with non-ionic, dimer, iso-osmolar contrast media in ERCP.
abstract: OBJECTIVE
  Pancreatitis is the most common and serious complication of endoscopic retrograde cholangiopancreatography (ERCP). Several studies have compared contrast media (CM) with different osmolalities, but the results are conflicting. We conducted this study to clarify the difference between 2 CM used in ERCP.
  
  
  METHODS
  Five hundred and seventy-six patients were examined by using ERCP in our hospital during 2010. Out of these, 56 patients were enrolled in this study. We investigated the incidence of post ERCP pancreatitis (PEP) and hyperamylasemia. Serum amylase levels were compared in the 2 groups.
  
  
  RESULTS
  Twenty-seven patients were treated with iodixanol and 29 with diatrizoate meglumine Na. The rate of PEP in the diatrizoate meglumine Na group and iodixanol group was 0% (0/29) and 7.4% (2/27), respectively (P = 0.228). The rate of hyperamylasemia was 10.3% (3/29) and 14.8% (4/27), respectively (P = 0.70). There were no significant differences between two groups for amylase levels pre-procedure (P = 0.082), 3 h post procedure (P = 0.744), or next morning (P = 0.265).
  
  
  CONCLUSIONS
  There were no significant differences in the rates of PEP or hyperamylasemia between CMs in ERCP. We believe it is unnecessary to use the more expensive low osmolality CM in ERCP to prevent PEP.
authors.affiliation: Department of Gastroenterology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan. ma_ogawa@tokai-u.jp.
authors.forename: Masami
authors.initials: M
authors.lastname: Ogawa
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Kawaguchi
authors.forename: Yohei
authors.initials: Y
authors.lastname: Kawashima
authors.forename: Hajime
authors.initials: H
authors.lastname: Mizukami
authors.forename: Atsuko
authors.initials: A
authors.lastname: Maruno
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Ito
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Mine
mesh_terms: D000368:Aged; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects* / Q000379:methods; D003287:Contrast Media / Q000009:adverse effects* / Q000737:chemistry / Q000191:economics; D019281:Dimerization; D005260:Female; D006801:Humans; D034321:Hyperamylasemia / Q000209:etiology / Q000517:prevention & control; D007477:Ions / Q000737:chemistry; D008297:Male; D008875:Middle Aged; D009994:Osmolar Concentration; D010195:Pancreatitis / Q000209:etiology* / Q000517:prevention & control*
chemical_list: D003287:Contrast Media; D007477:Ions