Pancreatic sphincter hypertension increases the risk of pancreatitis in patients undergoing ERCP.
However, glyceryl trinitrate reduces sphincter of Oddi pressure.
In this study, a research team from Spain tested the hypothesis that transdermal glyceryl trinitrate could be effective in the prevention of post-ERCP pancreatitis.
The researchers randomized 144 patients undergoing ERCP to 2 treatments.
|Development of post-ERCP pancreatitis:|
- Control = 11 cases
- Glyceryl trinitrate = 3 cases
One group, of 71 patients, received a 15 mg glyceryl trinitrate patch, while the control group of 73 patients received a placebo patch.
The team found that in the control group, post-ERCP pancreatitis developed in 11 patients, compared to 3 in the glyceryl trinitrate group.
In addition, 24 hour to baseline serum amylase, and lipase ratios were lower in the glyceryl trinitrate group. Results were 3.6 versus. 7.5, and 5.3 versus 27.7, respectively.
Multivariate analysis showed that glyceryl trinitrate patch and the number of pancreatic injections, but not endoscopic sphincterotomy, were independent risk factors for post-ERCP pancreatitis.
Dr Manuel Moretó's team concluded, "The results of this study suggest that use of a transdermal glyceryl trinitrate patch protects against post-ERCP pancreatitis".