Endoscopy 2008; 40(12): 1054
DOI: 10.1055/s-2008-1077715
Letters to the editor

© Georg Thieme Verlag KG Stuttgart · New York

Ethics in an animal study for interventional endoscopy

H.  Kakutani, Y.  Uchiyama, H.  Tajiri
Further Information

Publication History

Publication Date:
08 December 2008 (online)

The animal survival study using six dogs to determine causative factors of post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP) was published in Endoscopy [1]. Although PEP is one of the most severe complications of interventional endoscopy, I have serious doubts concerning the ethics of using animals for experimental purposes in this study and in other recent animal studies of novel endoscopic technologies. In the Buscaglia study, pancreatography was performed in the standard fashion. Results of hematologic tests and necropsy after the endoscopic pancreatography were stratified by the volume of the injected contrast media, existence or absence of papillary obstruction, with or without sphincterotomy and prophylactic pancreatic stent placement. The authors concluded that severe acinarization increased the risk and severity of PEP. As discussed in the article, it is well known that acinarization is a major risk factor for PEP [2] [3] [4] [5], and similar results have been reported from several clinical studies. Additionally, several randomized controlled studies have demonstrated that prophylactic stent placement effectively prevents the development of PEP [6]. All the authors found in this study was what was already known. I do believe that the sacrifice of animals should be confined by a proper institutional reviewing process and approved only for medical contribution, and not for obtaining academic kudos.

Competing interests: None

References

  • 1 Buscaglia J M, Simons B W, Prosser B J. et al . Severity of post-ERCP pancreatitis directly proportional to the invasiveness of endoscopic intervention: a pilot study in a canine model.  Endoscopy. 2008;  40 506-512
  • 2 Freeman M L, Nelson D B, Sherman S. et al . Complications of endoscopic biliary sphincterotomy.  N Engl J Med. 1996;  335 909-918
  • 3 Masci E, Toti G, Mariani A. et al . Complications of diagnostic and therapeutic ERCP: a prospective multicenter study.  Am J Gastroenterol. 2001;  96 417-423
  • 4 Freeman M L, Disario J A, Nelson D B. et al . Risk factors for post-ERCP pancreatitis: a prospective, multicenter study.  Gastrointest Endosc. 2001;  54 425-434
  • 5 Loperfido S, Angelini G, Benedetti G. et al . Major early complications from diagnostic and therapeutic ERCP: a prospective multicenter study.  Gastrointest Endosc. 1998;  48 1-10
  • 6 Freeman M L. Pancreatic stents for prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis.  Clin Gastroenterol Hepatol. 2007;  5 1354-1365

H. KakutaniMD, PhD 

Jikey University School of Medicine
Endoscopy

3-25-8 Nishi Shinbashi
Minato-ku
Tokyo 105-8461
Japan

+81-3-34594524

Email: endosc-kaku@jikei.ac.jp

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