A Comparison of a New Non-Ionic (Metrizamide) and a Dissociable (Metrizoate) Contrast Medium in Endoscopic Retrograde Pancreatography (ERP)

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Abstract
Endoscopic retrograde pancreatography (ERP) was performed on 12 patients with a non-ionic contrast medium (metrizamide) and a traditional dissociable medium (metrizoate). All patients were examined with both media at an interval of 1 wk. The study was based on double blind and a cross-over randomization. There was a significantly lower rise in serum amylase 2 (P = 0.05), 4 (P = 0.04) and 6 h (P = 0.03) after the examination using the non-ionic contrast medium than after using a dissociable one. The pain during contrast filling of the pancreas was significantly lower (P = 0.015) when using metrizamide than when using metrizoate. All except 1 patient preferred the examination with the non-ionic contrast medium (P = 0.0002). A positive correlation was found between pain and degree of pancreatic filling when using the dissociable medium (r [correlation coefficient] = 0.77). Such a correlation was not detected following the non-ionic contrast medium (r = 0.009). There was a positive correlation between rise in serum amylase and degree of pancreatic filling with both contrast media. The coefficient of correlation was lower after metrizamide (4 = 0.21) than after metrizoate (r = 0.56). A non-ionic contrast medium apparently was better tolerated than a dissociable medium, and metrizamide was more suitable for ERP than the traditional hypertonic contrast medium.