N-acetylcysteine does not prevent post-endoscopic retrograde cholangiopancreatography hyperamylasemia and acute pancreatitis

Table 1 Indications for ERCP in N-acetylcysteine treated group (ACC-group) and control group

ERCP indications	ACC group	Control group	P
Bile duct stones	35	32	NS
Recurrent pancreatitis	2	4	NS
Biliary pain, cholestasis	3	5	NS
Chronic pancreatitis	8	3	NS
Pancreatic cancer	3	1	NS
Other	4	6	NS

Table 2 ERCP procedure performed

ERCP procedure (patients)	ACC group	Control group
Diagnostic	4	2
Therapeutic	51	49
Endoscopic sphincterotomy	44	47

Table 3 Risk factors for acute pancreatitis

Risk factors (patients)	ACC group	Control group	Total	P
Gender (F/M)	33/22	33/18	66/40	NS
Multiple cannulations	9	7	16	NS
Pancreatic duct injections	13	12	25	NS
Diagnostic ERCP	5	1	6	NS
Failed procedure	2	3	5	NS
Precut papillotomy	12	9	21	NS
Small bile duct diameter	2	5	7	NS

Table 4 Unvariate analysis of group differences according to the presence of acute pancreatitis

Variables	Acutepancreatitis(n = 10)	No acutepancreatitis(n = 96)	P
N-acetylcysteine / Control	4/6	51/54	NS
Sex (F/M)	9/1	57/39	NS
Precut (Y/N)	6/4	15/81	0.004
Small bile duct diameter (Y/N)	1/9	6/90	NS
Multiple cannulations (Y/N)	5/5	11/85	0.006
Pancreatic duct injections (Y/N)	4/6	21/75	NS
Diagnostic ERCP (Y/N)	1/9	5/91	NS

Table 5 Serum and urine amylase activity before ERCP, after 8 and 24 h in control and ACC groups (mean ± SD)

Serum and urine amylaseactivity levels	Control group(%)	ACC group(%)	P
before ERCP serum	62.1 ± 59.7	79.0 ± 79.4	NS
urine	272.9 ± 320.5	268.1 ± 355.2	NS
8 h after ERCP serum	324.6 ± 487.1	270.1 ± 484.7	NS
urine	596.3 ± 1108.3	775.9 ± 1500.4	NS
24 h after ERCP serum	268.6 ± 590.9	183.56 ± 252.1	NS
urine	1324.8 ± 2763.9	1033.7 ± 2499.6	NS

Table 6 Summary of the results of forward selection multiple logistic-regression analysis with development of post-ERCP acute pancreatitis as the outcome variable

Variable1	Odds ratio	95% Cl	P
Precut (no precut vs precut)	0.108	0.026-0.456	0.003
Sex (F vs M)	7.432	0.841-65.689	0.071

¹ Other variables that were examined but did not enter the model including N-acetylcysteine treatment, multiple cannulations, bile duct diameter < 8 mm, injection of contrast into pancreatic duct, failed procedure and age.