Cargando…

Nafamostat for Prophylaxis against Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis Compared with Gabexate

BACKGROUND/AIMS: The protease inhibitors, nafamostat and gabexate, have been used to prevent pancreatitis related to endoscopic retrograde cholangiopancreatography (ERCP). In vitro, nafamostat inhibits the pancreatic protease activities 10-100 times more potently than gabexate. We evaluated the effi...

Descripción completa

Detalles Bibliográficos
Autores principales: Chang, Jae Hyuck, Lee, In Seok, Kim, Hyung Keun, Cho, Yu Kyung, Park, Jae Myung, Kim, Sang Woo, Choi, Myung-Gyu, Chung, In-Sik
Formato: Texto
Lenguaje:English
Publicado: The Korean Society of Gastroenterology; the Korean Society of Gastrointestinal Endoscopy; the Korean Association for the Study of the Liver; the Korean Society of Neurogastroenterology and Motility; Korean Association for the Study of Intestinal Diseases; Korean College of Helicobacter and Upper Gastrointestinal Research; Korean Society of Pancreatobiliary Diseases 2009
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2852705/
https://www.ncbi.nlm.nih.gov/pubmed/20431747
http://dx.doi.org/10.5009/gnl.2009.3.3.205
_version_ 1782179965795565568
author Chang, Jae Hyuck
Lee, In Seok
Kim, Hyung Keun
Cho, Yu Kyung
Park, Jae Myung
Kim, Sang Woo
Choi, Myung-Gyu
Chung, In-Sik
author_facet Chang, Jae Hyuck
Lee, In Seok
Kim, Hyung Keun
Cho, Yu Kyung
Park, Jae Myung
Kim, Sang Woo
Choi, Myung-Gyu
Chung, In-Sik
author_sort Chang, Jae Hyuck
collection PubMed
description BACKGROUND/AIMS: The protease inhibitors, nafamostat and gabexate, have been used to prevent pancreatitis related to endoscopic retrograde cholangiopancreatography (ERCP). In vitro, nafamostat inhibits the pancreatic protease activities 10-100 times more potently than gabexate. We evaluated the efficacy of nafamostat for prophylaxis against post-ERCP pancreatitis in comparison with gabexate. METHODS: Five hundred patients (208 patients in the nafamostat-treated group and 292 in the gabexate-treated group) were analyzed retrospectively after selective exclusion. The incidences of pancreatitis and hyperamylasemia after the ERCP were compared between the nafamostat and gabexate groups. RESULTS: The incidences of acute pancreatitis and hyperamylasemia were 9.1% and 40.9%, respectively, in the nafamostat-treated group, and 8.6% and 39.4% in the gabexate-treated group. The frequencies of post-ERCP pancreatitis and hyperamylasemia did not differ significantly between the two groups, Post-ERCP pancreatitis in two group did not vary according to the different ERCP procedures. The mean serum amylase level at 6 h after ERCP was significantly lower in the nafamostat-treated group than in the gabexate-treated group (p=0.020). However, the difference in serum amylase level did not persist at 18 h and 36 h post-ERCP. CONCLUSIONS: Administration of nafamostat before ERCP was not inferior to gabexate in protecting against the development of pancreatitis.
format Text
id pubmed-2852705
institution National Center for Biotechnology Information
language English
publishDate 2009
publisher The Korean Society of Gastroenterology; the Korean Society of Gastrointestinal Endoscopy; the Korean Association for the Study of the Liver; the Korean Society of Neurogastroenterology and Motility; Korean Association for the Study of Intestinal Diseases; Korean College of Helicobacter and Upper Gastrointestinal Research; Korean Society of Pancreatobiliary Diseases
record_format MEDLINE/PubMed
spelling pubmed-28527052010-04-29 Nafamostat for Prophylaxis against Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis Compared with Gabexate Chang, Jae Hyuck Lee, In Seok Kim, Hyung Keun Cho, Yu Kyung Park, Jae Myung Kim, Sang Woo Choi, Myung-Gyu Chung, In-Sik Gut Liver Original Article BACKGROUND/AIMS: The protease inhibitors, nafamostat and gabexate, have been used to prevent pancreatitis related to endoscopic retrograde cholangiopancreatography (ERCP). In vitro, nafamostat inhibits the pancreatic protease activities 10-100 times more potently than gabexate. We evaluated the efficacy of nafamostat for prophylaxis against post-ERCP pancreatitis in comparison with gabexate. METHODS: Five hundred patients (208 patients in the nafamostat-treated group and 292 in the gabexate-treated group) were analyzed retrospectively after selective exclusion. The incidences of pancreatitis and hyperamylasemia after the ERCP were compared between the nafamostat and gabexate groups. RESULTS: The incidences of acute pancreatitis and hyperamylasemia were 9.1% and 40.9%, respectively, in the nafamostat-treated group, and 8.6% and 39.4% in the gabexate-treated group. The frequencies of post-ERCP pancreatitis and hyperamylasemia did not differ significantly between the two groups, Post-ERCP pancreatitis in two group did not vary according to the different ERCP procedures. The mean serum amylase level at 6 h after ERCP was significantly lower in the nafamostat-treated group than in the gabexate-treated group (p=0.020). However, the difference in serum amylase level did not persist at 18 h and 36 h post-ERCP. CONCLUSIONS: Administration of nafamostat before ERCP was not inferior to gabexate in protecting against the development of pancreatitis. The Korean Society of Gastroenterology; the Korean Society of Gastrointestinal Endoscopy; the Korean Association for the Study of the Liver; the Korean Society of Neurogastroenterology and Motility; Korean Association for the Study of Intestinal Diseases; Korean College of Helicobacter and Upper Gastrointestinal Research; Korean Society of Pancreatobiliary Diseases 2009-09 2009-09-30 /pmc/articles/PMC2852705/ /pubmed/20431747 http://dx.doi.org/10.5009/gnl.2009.3.3.205 Text en Copyright © 2009 The Korean Society of Gastroenterology; the Korean Society of Gastrointestinal Endoscopy; the Korean Association for the Study of the Liver; the Korean Society of Neurogastroenterology and Motility; Korean Association for the Study of Intestinal Diseases; Korean College of Helicobacter and Upper Gastrointestinal Research; Korean Society of Pancreatobiliary Diseases
spellingShingle Original Article
Chang, Jae Hyuck
Lee, In Seok
Kim, Hyung Keun
Cho, Yu Kyung
Park, Jae Myung
Kim, Sang Woo
Choi, Myung-Gyu
Chung, In-Sik
Nafamostat for Prophylaxis against Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis Compared with Gabexate
title Nafamostat for Prophylaxis against Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis Compared with Gabexate
title_full Nafamostat for Prophylaxis against Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis Compared with Gabexate
title_fullStr Nafamostat for Prophylaxis against Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis Compared with Gabexate
title_full_unstemmed Nafamostat for Prophylaxis against Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis Compared with Gabexate
title_short Nafamostat for Prophylaxis against Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis Compared with Gabexate
title_sort nafamostat for prophylaxis against post-endoscopic retrograde cholangiopancreatography pancreatitis compared with gabexate
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2852705/
https://www.ncbi.nlm.nih.gov/pubmed/20431747
http://dx.doi.org/10.5009/gnl.2009.3.3.205
work_keys_str_mv AT changjaehyuck nafamostatforprophylaxisagainstpostendoscopicretrogradecholangiopancreatographypancreatitiscomparedwithgabexate
AT leeinseok nafamostatforprophylaxisagainstpostendoscopicretrogradecholangiopancreatographypancreatitiscomparedwithgabexate
AT kimhyungkeun nafamostatforprophylaxisagainstpostendoscopicretrogradecholangiopancreatographypancreatitiscomparedwithgabexate
AT choyukyung nafamostatforprophylaxisagainstpostendoscopicretrogradecholangiopancreatographypancreatitiscomparedwithgabexate
AT parkjaemyung nafamostatforprophylaxisagainstpostendoscopicretrogradecholangiopancreatographypancreatitiscomparedwithgabexate
AT kimsangwoo nafamostatforprophylaxisagainstpostendoscopicretrogradecholangiopancreatographypancreatitiscomparedwithgabexate
AT choimyunggyu nafamostatforprophylaxisagainstpostendoscopicretrogradecholangiopancreatographypancreatitiscomparedwithgabexate
AT chunginsik nafamostatforprophylaxisagainstpostendoscopicretrogradecholangiopancreatographypancreatitiscomparedwithgabexate