Martín Arranz Eduardo, Rey Sanz Rafael, Martín Arranz María Dolores, Gea Rodríguez Francisco, Mora Sanz Pedro
Servicio de Aparato Digestivo, Hospital Universitario La Paz, Madrid, España.
Gastroenterol Hepatol. 2011 Dec;34(10):672-7. doi: 10.1016/j.gastrohep.2011.09.001. Epub 2011 Nov 25.
Radiologic contrasts are required during endoscopic retrograde cholangiopancreatography (ERCP). The most frequently used are iodine-based contrast media. Controversy still surrounds the optimal strategy in patients with previous adverse reactions to iodine contrasts that need to undergo an ERCP.
To evaluate the safety and efficacy of a gadolinium-derived contrast medium in patients with previous reactions to iodine-derived agents during ERCP.
Thirteen ERCP were performed in 11 patients with well-established adverse reactions to iodine compounds. ERCP was carried out with gadobutrol, a non-ionic gadolinium compound and without prophylaxis.
In all patients, ERCP were satisfactorily completed. Thirteen cholangiograms and one pancreatogram were obtained. All procedures were technically successful, allowing diagnosis and endotherapy. The quality of the images was good, similar to those obtained with standard contrast media, and did not represent a limitation. No contrast-related adverse events were observed, and there were no post-ERCP complications.
Gadolinium-derived agents are a safe and effective alternative in iodine-allergic patients.
内镜逆行胰胆管造影（ERCP）期间需要使用放射学造影剂。最常用的是碘基造影剂。对于既往对碘造影剂有不良反应且需要进行ERCP的患者，最佳策略仍存在争议。
评估钆基造影剂在既往对碘基造影剂有反应的患者进行ERCP时的安全性和有效性。
对11例对碘化合物有明确不良反应的患者进行了13次ERCP。使用钆布醇（一种非离子型钆化合物）进行ERCP，且未采取预防措施。
所有患者的ERCP均顺利完成。获得了13张胆管造影照片和1张胰腺造影照片。所有操作在技术上均成功，可进行诊断和内镜治疗。图像质量良好，与使用标准造影剂获得的图像相似，且不构成限制。未观察到与造影剂相关的不良事件，且ERCP后无并发症。
钆基造影剂在碘过敏患者中是一种安全有效的替代选择。
