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Digestive Diseases and Sciences

, Volume 62, Issue 4, pp 1043–1050 | Cite as

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

  • Chong Wang
  • Qirui Li
  • Peng Ye
  • Sheng Zeng
  • Guo-Hua LiEmail author
  • You-Xiang Chen
  • Xiao-Jiang Zhou
  • Nong-Hua LvEmail author
Original Article
  • 230 Downloads

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.

Keywords

Raw rhubarb Post-ERCP pancreatitis (PEP) Hyperamylasemia Endoscopic retrograde cholangiopancreatography (ERCP) 

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

Notes

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.

Compliance with ethical standards

Conflicts of interest

The authors have no conflicts of interest to disclose.

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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Chong Wang
    • 1
  • Qirui Li
    • 2
  • Peng Ye
    • 3
  • Sheng Zeng
    • 1
  • Guo-Hua Li
    • 1
    Email author
  • You-Xiang Chen
    • 1
  • Xiao-Jiang Zhou
    • 1
  • Nong-Hua Lv
    • 1
    Email author
  1. 1.Department of GastroenterologyThe First Affiliated Hospital of Nanchang UniversityNanchangChina
  2. 2.Medical College of Nanchang UniversityNanchangChina
  3. 3.Department of GastroenterologyThe People Hospital of Ganzhou CityGanzhouChina

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