Diagnostic quality in endoscopic retrograde cholangiopancreatography: Comparison between Iodixanol and Iopromide

Background and Study Aims: The contrast medium for endoscopic retrograde ch olangiopancreatography (ERCP) must produce adequate images, whilst keeping the risk of complications to a minimum. There is a theoretical reason to su ppose that a dimeric isosmolar medium may be superior to a monomeric hypero smolar medium. We have compared two such media in a triple-centre double-bl ind randomized study on patients referred with a clinical indication for ER CP. Patients and Methods: A total of 160 patients were randomly allocated to ei ther Iodixanol or Iopromide, 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 Iodixanol, there were no differences between the two groups. The overall frequencies of adverse events were similar. Conclusions: Iodixanol is a safe and effective water-soluble contrast mediu m for ERCP, comparable to Iopromide, but despite theoretical advantages Iod ixanol has no clear practical benefit.