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KMID : 1188320090030030205
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Gut and Liver
2009 Volume.3 No. 3 p.205 ~ p.210
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Nafamostat for Prophylaxis against Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis Compared with Gabexate
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Chang Jae-Hyuck
Lee In-Seok
Kim Hyung-Keun
Cho Yu-Kyung
Park Jae-Myung
Kim Sang-Woo
Choi Myung-Gyu
Chung In-Sik
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Abstract
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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.
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KEYWORD
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Gabexate, Nafamostat, Endoscopic retrograde cholangiopancreatography, Pancreatitis, Hyperamylasemia
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