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Value of Raw Rhubarb Solution in the Precaution of Post-endoscopic Retrograde Cholangiopancreatography Pancreatitis in Patients with High-Risk Factors: A Predictive Random Compared Research in One Center

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Abstract

Background and aims

Post-ERCP pancreatitis and hyperamylasemia are common complications of endoscopic retrograde cholangiopancreatography (ERCP), especially in high-risk patients. The aim of this study is to evaluate whether a raw rhubarb solution can reduce the incidence of PEP and post-ERCP hyperamylasemia.

Methods

From October 2012 to October 2013, 2100 patients received ERCP in our Endoscopic Center. Five hundred patients with high-risk factors were enrolled randomly into the raw rhubarb group (RG, 250 cases drank a raw rhubarb soak solution per 3 h until defecation after ERCP) and the control group (CG, 250 cases drank water after ERCP) in the study. The serum amylase concentration was measured. The abdominal pain, purge time and symptoms of patients were observed in the two groups.

Results

There were no differences in patient demographics, medical history, ERCP procedure, and patient- and procedure-related high-risk factors between the two groups. PEP incidence was 2% (5/250) in the RG group, which was lower than that in the CG group (7.6%, 19/250) (P < 0.01). The rate of post-ERCP hyperamylasemia was 5.2% (13/250) and 16.8% (42/250) in the RG group and CG group, respectively. The incidence of hyperamylasemia in the RG group was significantly lower than that in the CG group (P < 0.01). The incidence of abdominal pain 24 h after ERCP in the RG group was lower than that in the CG group (P < 0.01). No side effects were observed for raw rhubarb solution.

Conclusions

A raw rhubarb solution is safe and effective in preventing the incidence of PEP and hyperamylasemia in high-risk patients.

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Abbreviations

PEP:

Post-ERCP pancreatitis

ERCP:

Endoscopic retrograde cholangiopancreatography

RG:

Raw rhubarb group

CG:

Control group

AP:

Acute pancreatitis

SOD:

Sphincter of Oddi dysfunction

NSAIDs:

Nonsteroidal anti-inflammatory drugs

WHO ICTRP:

The International Clinical Trials Registry Platform from the World Health Organization

CT:

Computed tomography

WBC:

White blood cell count

ALT:

Alanine aminotransferase

TBIL:

Total bilirubin

NG:

Nitroglycerin

PDE:

Phosphodiesterase

IL-10:

Interleukin-10

ENBD:

Endoscopic naso-biliary drainage

EPBD:

Endoscopic papillary balloon dilatation

BD:

Bile duct

MPO:

Myeloperoxidase

SDF-1:

Stromal cell-derived factor-1

TLRs:

Toll-like receptors

SERCA2:

Sarcoplasmic reticulum Ca2+-adenosinetriphosphatase

SD:

Standard deviation

ANOVA:

Analysis of variance

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Acknowledgments

The study was supported by the Public Health Office of Jiangxi Province of China (grant no. 20155161) and the First Affiliated Hospital of Nanchang University.

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Authors and Affiliations

  1. Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China

    Chong Wang, Sheng Zeng, Guo-Hua Li, You-Xiang Chen, Xiao-Jiang Zhou & Nong-Hua Lv

  2. Medical College of Nanchang University, Nanchang, Jiangxi Province, China

    Qirui Li

  3. Department of Gastroenterology, The People Hospital of Ganzhou City, Ganzhou, Jiangxi Province, China

    Peng Ye

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  1. Chong Wang
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Correspondence to Guo-Hua Li or Nong-Hua Lv.

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Qirui Li is the common first author.

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Wang, C., Li, Q., Ye, P. et al. Value of Raw Rhubarb Solution in the Precaution of Post-endoscopic Retrograde Cholangiopancreatography Pancreatitis in Patients with High-Risk Factors: A Predictive Random Compared Research in One Center. Dig Dis Sci 62, 1043–1050 (2017). https://doi.org/10.1007/s10620-017-4464-7

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  • DOI: https://doi.org/10.1007/s10620-017-4464-7

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