Diagnostic Quality in Endoscopic Retrograde Cholangiopancreatography: Comparison Between Iodixanol and Iopromide
D. F. Martin 1
, R. E. England 1
, T. Rösch 2
, E. Biehl 2
, B. Jeschke 2
, N. Fritz 2
, D. Heldwein 3
, A. Klauser 3
, A. Klaveness 4
, D. Kristoffersen 4
1 Dept. of Radiology, South Manchester University Hospitals, Withington Hospital, Manchester, UK
2 Dept. of Internal Medicine II, Technical University of Munich, Munich, Germany
3 MCHE Klinik, K Innenstadt, Ludwig-Maximilians University, Munich, Germany
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 Iodixanol or Iopromide. 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 Iodixanol, there were no differences between the two groups. The overall frequencies of adverse events were similar.
Conclusions: Iodixanol is a safe and effective water-soluble contrast medium for ERCP, comparable to Iopromide, but despite theoretical advantages Iodixanol has no clear practical benefit.
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