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BACKGROUND:Despite the recent improvement in techniques and patient selection, post-ERCPpancreatitis remains the most frequent and dreaded complication of ERCP. Recentstudies suggest that pretreatment with glyceryl trinitrate (GTN) may preventpost-ERCP pancreatitis and improve cannulation success. OBJECTIVE: To evaluatethe effect of transdermal GTN on ERCP cannulation success and post-ERCPpancreatitis. DESIGN: Prospective, double-blind, placebo-controlled trial.SETTING: Tertiary referral university hospital. PATIENTS: A total of 318patients (mean age 62 years, 61% women) were randomized to either active (n =155) or placebo (n = 163) arms. INTERVENTIONS: Active patch (GTN) versusplacebo patch. MAIN OUTCOME MEASUREMENTS: Cannulation time and success.Post-ERCP pancreatitis rates. RESULTS: There was no significant differencebetween the active or placebo arms for the following: successful initialcannulation (96.8% vs 98.8%), deep cannulation (96.1% vs 98.8%), time tosuccessful cannulation, use of guidewire (27% vs 25%) or needle knife (13% vs13%), and post-ERCP pancreatitis (7.4% of placebo patients and 7.7% activepatients). Multivariate analysis identified women, younger patients,pancreatogram, number of attempts on papilla, and poor pancreatic-duct emptyingafter opacification as risk factors for post-ERCP pancreatitis. Transdermal GTNdid not reduce post-ERCP pancreatitis in any of the identified high-riskgroups. CONCLUSIONS: Transdermal GTN did not improve the rate of success inERCP cannulation or prevent post-ERCP pancreatitis in either average orhigh-risk patient groups. Leggil'articolo Full-text disponibile per i soci AIGO!!!!