Frequency of post-ERCP pancreatitis in a single tertiary referral centre without and with routine prophylaxis with gabexate: a 6-year survey and cost-effectiveness analysis.
Dig Liver Dis
; 38(8): 588-95, 2006 Aug.
Article
en En
| MEDLINE
| ID: mdl-16731060
ABSTRACT
BACKGROUND AND STUDY AIMS:
Several drugs have been used for the prevention of post-ERCP pancreatitis with conflicting results and no data referring to the routine use of a pharmacological prophylaxis have been published up to now. Aim of the study was to evaluate the frequency of post-ERCP pancreatitis and costs in a series of consecutive patients who have undergone ERCP procedures before and after the introduction of a routine prophylaxis with gabexate in all cases. PATIENTS ANDMETHODS:
Data from 1312 patients who underwent ERCP procedures without gabexate prophylaxis and from 1149 consecutive patients with 1g i.v. gabexate, were retrospectively evaluated during a 6-year period. Patients were also subdivided in standard- and high-risk subjects, on the basis of patient- and technique-related risk factors 984 subjects (39.9%) had one or more conditions that placed them at high risk for post-ERCP pancreatitis.RESULTS:
Post-ERCP pancreatitis was reported in 76 out of 2461 patients (3.1%). The frequency of pancreatitis appeared significantly reduced in the gabexate period in comparison with before gabexate in overall cases (2.2% versus 3.9%; p=0.019); however, the reduction was significant only for high-risk patients (3.8% versus 7.3%; p=0.001). Severe hyperamylasaemia at 4-6h and 24h after the procedure was also significantly reduced only in high-risk patients (p=0.001). Routine prophylaxis with gabexate appeared cost-effective in high-risk patients.CONCLUSIONS:
Routine gabexate prophylaxis was associated with a significant reduction of post-ERCP pancreatitis rate, severe hyperamylasaemia and hospitalisation-related costs only in high-risk patients. However, gabexate appeared unable to reduce the incidence of severe pancreatitis.
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Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Pancreatitis
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Inhibidores de Serina Proteinasa
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Colangiopancreatografia Retrógrada Endoscópica
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Gabexato
Tipo de estudio:
Etiology_studies
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Health_economic_evaluation
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Incidence_studies
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Observational_studies
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Prognostic_studies
Límite:
Adolescent
/
Adult
/
Aged
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Aged80
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Child
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Child, preschool
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Female
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Humans
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Male
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Middle aged
País/Región como asunto:
Europa
Idioma:
En
Revista:
Dig Liver Dis
Asunto de la revista:
GASTROENTEROLOGIA
Año:
2006
Tipo del documento:
Article
País de afiliación:
Italia