الفهرس 
Anatomy of the Biliary SystemOnly 14 pages are availabe for public view
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Abstract
BACKGROUND: ERCP has become popular worldwide because it can provide significant benefit in many clinical contexts. Sadly, it has also caused considerable harm in a small number of patients. Thus, it is crucial for practitioners and potential patients to understand the predictors of benefit, and of risk.Of these harmful outcomes is post ERCP pancereatitis and this study was conducted to prevent this unpleasant sequale.
AIM THE WORK: To study if the oral (ARB) losartan counteracts pancereatitis and panceriatic hyperenzymemia as measured 24 h after (ERCP).
PATIENT AND METHODS: A double-blind controlled randomized clinical trial was performed at Ain Shams University Hospital. Patients over 18 years of age undergoing ERCP, excluding those with current pancreatitis, current use of ARB, and severe disease, such as sepsis, liver and renal failure. One oral dose of 50 mg losartan was given one hour before ERCP. The relative risk of hyperenzymemia 24 h after ERCP was estimated using multivariable logistic regression, and expressed as odds ratio with 95% confidence intervals (CIs), including adjustment for potential remaining confounding.
RESULTS: Among 100 participating patients, 50 were randomized to the losartan and the control group, respectively. The incidence rates of hyperenzymemia and acute pancreatitis among all participating patients were 54 % and 3%, respectively. Hyperenzymemia was detected in 38 and 16 patients in the losartan and control group, respectively. There were no major differences between the comparison groups regarding cannulation difficulty, findings, or proportion of patients requiring drainage of the bile ducts.
CONCLUSION: In this randomized trial 50 mg losartan given orally had no prophylactic effect on development of hyperenzymemia and pancereatitis after ERCP.