Ulinastatin Prevents Post-ERCP Pancreatitis

Gabexate, a protease inhibitor, reduces the incidence of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis. Because this agent must be infused continuously for as long as 13 hours, it is not useful for preventing pancreatitis among patients who receive ERCP in the outpatient setting, which is common practice in the U.S. Ulinastatin, an endogenous trypsin inhibitor, has a relatively long half-life compared with gabexate and can be administered as a bolus injection.

Japanese researchers evaluated the efficacy of 10-minute infusions of ulinastatin for preventing post-ERCP pancreatitis in a randomized, double-blind, controlled trial in 406 patients. Diagnosis of pancreatitis and severity grading were based on standardized c…