Diagnostic quality in endoscopic retrograde cholangiopancreatography: comparison between lodixanol and lopromide.

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 lodixanol or lopromide. 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 lodixanol, there were no differences between the two groups. The overall frequencies of adverse events were similar

CONCLUSIONS

lodixanol is a safe and effective water-soluble contrast medium for ERCP, comparable to lopromide, but despite theoretical advantages lodixanol has no clear practical benefit.