EFFICACY OF 20 MG/DAY OF NAFAMOSTAT MESYLATE IN PREVENTING POST ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY PANCREATITIS

Abstract

Aim : To assess the efficacy of nafamostat mesylate in preventing post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis.
Methods : Included in this study were 250 naive papilla patients without pancreatitis or gastrectomy out of 570 consecutive patients who underwent ERCP without prophylactic 20 mg/day of nafamostat mesylate administration (group A) and 250 naive papilla patients without pancreatitis or gastrectomy out of 586 consecutive patients with such administration (group B). The incidences of post-ERCP pancreatitis (PEP) and hyperamylasemia in each group were retrospectively investigated. Risk factors for the development of PEP were also evaluated.
Results : There was no significant difference in the incidences of PEP and hyperamylasemia between group A and group B (4% vs. 4%, p = 1.0 ; 18% vs. 18%, p = 0.91, respectively). In group A, nafamostat mesylate was administered in only 12% of the cases based on the serum amylase level 3 hours after ERCP and clinical manifestations. Multivariate analysis revealed that the only risk factor for PEP was the requirement of over 45 minutes for ERCP. Conclusion : It was suggested that prophylactic 20 mg/day of nafamostat mesylate administration in all ERCP cases does not influence the incidence of PEP.