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[ERCP: which contrast medium is suitable?].

A Rambow1, M Staritz, M Manns

  • 1I. Medizinische Klinik und Poliklinik, Johannes-Gutenberg-Universität Mainz.

Zeitschrift Fur Gastroenterologie
|May 1, 1988
PubMed
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This study compared contrast media for endoscopic retrograde cholangiopancreaticography (ERCP). Low-viscosity agents like Ultravist and Rayvist showed fewer side effects than Hexabrix, suggesting careful contrast selection can improve ERCP safety.

Area of Science:

  • Gastroenterology
  • Medical Imaging

Background:

  • Endoscopic retrograde cholangiopancreatography (ERCP) is a key diagnostic and therapeutic procedure.
  • Assessing the impact of different contrast media on ERCP complication rates is crucial for patient safety.

Purpose of the Study:

  • To evaluate if a new non-ionic contrast medium reduces complications during ERCP.
  • To compare the safety and efficacy of non-ionic (Ultravist), high-osmolar (Rayvist), and conventional (Hexabrix) contrast media.

Main Methods:

  • A prospective randomized study involving 46 patients with suspected pancreatic or bile duct diseases.
  • Comparison of three contrast media: low-osmolar non-ionic Iopromid (Ultravist), low-viscosity high-osmolar Ioglicinate (Rayvist), and high-viscosity Ioxaglinate (Hexabrix).
  • Monitoring of patient complications, particularly pancreatitis, and biochemical markers (liver enzymes, lipase, amylase).

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Main Results:

  • All contrast media provided excellent imaging of pancreatic and bile ducts.
  • No ERCP-related complications, including pancreatitis, were observed in any group.
  • Hexabrix administration led to significant elevations in gamma-GT and lipase levels (p < 0.01).
  • Ultravist and Rayvist did not cause significant changes in measured biochemical markers.

Conclusions:

  • ERCP performed by experienced professionals is a low-risk procedure.
  • The choice of contrast medium can influence hepatotoxic and pancreatotoxic side effects.
  • Low-viscosity contrast media (Ultravist, Rayvist) are recommended over high-viscosity ones like Hexabrix.
  • The specific benefit of the non-ionic contrast medium (Ultravist) was not demonstrated in this study.