Milewski J, Rydzewska G, Degowska M, Kierzkiewicz M, Rydzewski A. N-acetylcysteine does not prevent post-endoscopic retrograde cholangiopancreatography hyperamylasemia and acute pancreatitis. World J Gastroenterol 2006; 12(23): 3751-3755 [PMID: 16773694 DOI: 10.3748/wjg.v12.i23.3751]
Corresponding Author of This Article
Professor Grazyna Rydzewska MD, PhD, Department of Internal Medicine and Gastroenterology, Central Clinical Hospital of Ministry of Internal Affairs, Woloska str. 137, 02- 507 Warsaw, Poland. grazyna.rydzewska@cskmswia.pl
Article-Type of This Article
Rapid Communication
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World J Gastroenterol. Jun 21, 2006; 12(23): 3751-3755 Published online Jun 21, 2006. doi: 10.3748/wjg.v12.i23.3751
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
Citation: Milewski J, Rydzewska G, Degowska M, Kierzkiewicz M, Rydzewski A. N-acetylcysteine does not prevent post-endoscopic retrograde cholangiopancreatography hyperamylasemia and acute pancreatitis. World J Gastroenterol 2006; 12(23): 3751-3755