Magnesium Sulfate for Prevention of Post-ERCP-Pancreatitis: A Randomized Controlled Trial

Author:

Aletaha Najmeh1ORCID,Hamid Hoda1ORCID,Alipour Abbas2,Ketabi Moghadam Pardis3

Affiliation:

1. Gastroenterology Department, Tehran University of Medical Sciences, Tehran, Iran

2. Thalassemia Research Center, Mazandaran University of Medical Sciences, Sari, Iran

3. Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti Medical University, Tehran, Iran

Abstract

Background: Acute pancreatitis is one of the most common complications of endoscopic retrograde cholangiopancreatography (ERCP). Studies suggest that intrapancreatic calcium has an important role in activating pancreatic enzymes; in addition, elevated intraductal pressure is required for development of pancreatitis. Magnesium sulfate (MS), as a calcium antagonist and a muscle relaxant of the Oddi sphincter, is suggested to reduce the incidence and severity of post-ERCP-pancreatitis (PEP) in this article. Methods: We included 270 patients who referred for ERCP between March 2017 and March 2018. They were enrolled into MS (2 g) and placebo (normal saline) groups, administered 1 hour before and 6 hours after the procedure. The ERCPs were done by fellows of gastroenterology under supervision of expert physicians. The incidence and severity of PEP were followed. Results: PEP was seen in 12 (8.9%) patients in the MS group and 17 (12.6%) in the placebo group (P value=0.33). The incidence of PEP in high risk patients group (P value=0.017). Conclusion: Although the usage of MS was not able to prevent PEP in all patients enrolled in this study, but it could significantly reduce the incidence of PEP in high risk patients of intervention group in comparison with placebo group. The median length of hospital stay was also significantly lower in new drug group in contrast to placebo.

Publisher

Maad Rayan Publishing Company

Subject

General Medicine

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