Bacteriostatic saline (BS) vs non-bacteriostatic saline (NBS) as a contrast media diluant for ERCP

Is there a difference in post-ERCP pancreatitis incidence? A prospective study

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Abstract

BACKGROUND: We routinely used BS to dilute ERCP contrast media in hopes of limiting bacterial contamination. BS contains the bacteriostatic agent benzyl alcohol (0.9%). We observed that BS alone, when placed in the conjunctiva as eye drops, caused marked erythema and pain. We were then concerned that BS may be contributing to post-ERCP pancreatitis. METHODS: From 8/95-12/96,1735 patients were randomized to BS or NBS in the contrast media on alternating days. The contrast media used was 50% Hypaque sodium (Diatrizoate sodium, Nycomed Inc.) forpancreatography (containing no benzyl alcohol) and 25% (via dilution with NBS or BS) for biliary studies. BS potentially irritated the pancreas when biliary contrast media entered the pancreas during attempts at cholangiography A diagnosis of post-ERCP pancreatitis was made based on the Cotton criteria (Gastrointest Endosc 1991;37:383). Influence of procedure type (diagnostic, therapeutic, sphincter of Oddi manometry) was also assessed. RESULTS: 135/1735 patients (7.8%) developed post-ERCP pancreatitis. PANCREATITIS FREQUENCY AND SEVERITY Mild Moderate Severe Total Bacteriostatic Saline 54(6.4%) 10(1.2%) 3(0.4%) 67/838(8.0%) Non-bacteriostatic Saline 53(5.9%) 12(1.3%) 3(0.3%) 68/897(7.6%) There were no differences in pancreatitis frequency between BS and NBS as a whole or among the various diagnostic and therapeutic categories. CONCLUSION: Bacteriostatic saline does not appear to contribute to post-ERCP pancreatitis.

Original languageEnglish
JournalGastrointestinal Endoscopy
Volume45
Issue number4
StatePublished - 1997

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Endoscopic Retrograde Cholangiopancreatography
Pancreatitis
Contrast Media
Prospective Studies
Incidence
Benzyl Alcohol
Diatrizoate
Pancreas
Sphincter of Oddi
Cholangiography
Ophthalmic Solutions
Conjunctiva
Manometry
Erythema
Sodium
Pain
Therapeutics

ASJC Scopus subject areas

  • Gastroenterology

Cite this

@article{ed4b04f2694a49f6abd8e62a87303942,
title = "Bacteriostatic saline (BS) vs non-bacteriostatic saline (NBS) as a contrast media diluant for ERCP: Is there a difference in post-ERCP pancreatitis incidence? A prospective study",
abstract = "BACKGROUND: We routinely used BS to dilute ERCP contrast media in hopes of limiting bacterial contamination. BS contains the bacteriostatic agent benzyl alcohol (0.9{\%}). We observed that BS alone, when placed in the conjunctiva as eye drops, caused marked erythema and pain. We were then concerned that BS may be contributing to post-ERCP pancreatitis. METHODS: From 8/95-12/96,1735 patients were randomized to BS or NBS in the contrast media on alternating days. The contrast media used was 50{\%} Hypaque sodium (Diatrizoate sodium, Nycomed Inc.) forpancreatography (containing no benzyl alcohol) and 25{\%} (via dilution with NBS or BS) for biliary studies. BS potentially irritated the pancreas when biliary contrast media entered the pancreas during attempts at cholangiography A diagnosis of post-ERCP pancreatitis was made based on the Cotton criteria (Gastrointest Endosc 1991;37:383). Influence of procedure type (diagnostic, therapeutic, sphincter of Oddi manometry) was also assessed. RESULTS: 135/1735 patients (7.8{\%}) developed post-ERCP pancreatitis. PANCREATITIS FREQUENCY AND SEVERITY Mild Moderate Severe Total Bacteriostatic Saline 54(6.4{\%}) 10(1.2{\%}) 3(0.4{\%}) 67/838(8.0{\%}) Non-bacteriostatic Saline 53(5.9{\%}) 12(1.3{\%}) 3(0.3{\%}) 68/897(7.6{\%}) There were no differences in pancreatitis frequency between BS and NBS as a whole or among the various diagnostic and therapeutic categories. CONCLUSION: Bacteriostatic saline does not appear to contribute to post-ERCP pancreatitis.",
author = "Evan Fogel and D. Earle and Stuart Sherman and Glen Lehman",
year = "1997",
language = "English",
volume = "45",
journal = "Gastrointestinal Endoscopy",
issn = "0016-5107",
publisher = "Mosby Inc.",
number = "4",

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TY - JOUR

T1 - Bacteriostatic saline (BS) vs non-bacteriostatic saline (NBS) as a contrast media diluant for ERCP

T2 - Is there a difference in post-ERCP pancreatitis incidence? A prospective study

AU - Fogel, Evan

AU - Earle, D.

AU - Sherman, Stuart

AU - Lehman, Glen

PY - 1997

Y1 - 1997

N2 - BACKGROUND: We routinely used BS to dilute ERCP contrast media in hopes of limiting bacterial contamination. BS contains the bacteriostatic agent benzyl alcohol (0.9%). We observed that BS alone, when placed in the conjunctiva as eye drops, caused marked erythema and pain. We were then concerned that BS may be contributing to post-ERCP pancreatitis. METHODS: From 8/95-12/96,1735 patients were randomized to BS or NBS in the contrast media on alternating days. The contrast media used was 50% Hypaque sodium (Diatrizoate sodium, Nycomed Inc.) forpancreatography (containing no benzyl alcohol) and 25% (via dilution with NBS or BS) for biliary studies. BS potentially irritated the pancreas when biliary contrast media entered the pancreas during attempts at cholangiography A diagnosis of post-ERCP pancreatitis was made based on the Cotton criteria (Gastrointest Endosc 1991;37:383). Influence of procedure type (diagnostic, therapeutic, sphincter of Oddi manometry) was also assessed. RESULTS: 135/1735 patients (7.8%) developed post-ERCP pancreatitis. PANCREATITIS FREQUENCY AND SEVERITY Mild Moderate Severe Total Bacteriostatic Saline 54(6.4%) 10(1.2%) 3(0.4%) 67/838(8.0%) Non-bacteriostatic Saline 53(5.9%) 12(1.3%) 3(0.3%) 68/897(7.6%) There were no differences in pancreatitis frequency between BS and NBS as a whole or among the various diagnostic and therapeutic categories. CONCLUSION: Bacteriostatic saline does not appear to contribute to post-ERCP pancreatitis.

AB - BACKGROUND: We routinely used BS to dilute ERCP contrast media in hopes of limiting bacterial contamination. BS contains the bacteriostatic agent benzyl alcohol (0.9%). We observed that BS alone, when placed in the conjunctiva as eye drops, caused marked erythema and pain. We were then concerned that BS may be contributing to post-ERCP pancreatitis. METHODS: From 8/95-12/96,1735 patients were randomized to BS or NBS in the contrast media on alternating days. The contrast media used was 50% Hypaque sodium (Diatrizoate sodium, Nycomed Inc.) forpancreatography (containing no benzyl alcohol) and 25% (via dilution with NBS or BS) for biliary studies. BS potentially irritated the pancreas when biliary contrast media entered the pancreas during attempts at cholangiography A diagnosis of post-ERCP pancreatitis was made based on the Cotton criteria (Gastrointest Endosc 1991;37:383). Influence of procedure type (diagnostic, therapeutic, sphincter of Oddi manometry) was also assessed. RESULTS: 135/1735 patients (7.8%) developed post-ERCP pancreatitis. PANCREATITIS FREQUENCY AND SEVERITY Mild Moderate Severe Total Bacteriostatic Saline 54(6.4%) 10(1.2%) 3(0.4%) 67/838(8.0%) Non-bacteriostatic Saline 53(5.9%) 12(1.3%) 3(0.3%) 68/897(7.6%) There were no differences in pancreatitis frequency between BS and NBS as a whole or among the various diagnostic and therapeutic categories. CONCLUSION: Bacteriostatic saline does not appear to contribute to post-ERCP pancreatitis.

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