RESUMO
BACKGROUND AND STUDY AIMS: The contrast medium for endoscopic retrograde cholangiopancreatography (ERCP) must produce adequate images, whilst keeping the risk of complications to a minimum. There is a theoretical reason to suppose that a dimeric isosmolar medium may be superior to a monomeric hyperosmolar medium. We have compared two such media in a triple-centre double-blind randomized study on patients referred with a clinical indication for ERCP. PATIENTS AND METHODS: A total of 160 patients were randomly allocated to either lodixanol or lopromide. Assessments were made of the quality of images and the complications encountered. RESULTS: A total of 151 patients were evaluated. Apart from a trend towards better diagnostic quality for main pancreatic duct imaging with lodixanol, there were no differences between the two groups. The overall frequencies of adverse events were similar CONCLUSIONS: lodixanol is a safe and effective water-soluble contrast medium for ERCP, comparable to lopromide, but despite theoretical advantages lodixanol has no clear practical benefit.