The probability of pancreatitis after pancreatic parenchymatography with a non-ionic contrast medium. A sequentially designed clinical trial.

Endoscopic retrograde pancreatography (ERP) with parenchymatous contrast filling may result in clinical pancreatitis. The aim of the present prospective trial was to assess the frequency of acute pancreatitis after pancreatic parenchymatography with a non-ionic contrast medium, metrizamide. For ethical reasons the examination was designed as a sequential study with clearly defined stopping rules. None of the 48 patients studied developed clinical pancreatitis. This indicates that the probability of pancreatitis after parenchymatography is less than 5%. A high degree of contrast filling was obtained both in patients with normal and in those with pathologic pancreatic ducts. The contrast filling of the ducts was associated with not more than a slight pain. The rise in serum amylase was considerable but was not associated with clinical pancreatitis and returned to preexamination levels within 48 h. The examination shows that the non-ionic contrast medium used is well tolerated in ERP.