Can Somatostatin Prevent Post-ERCP Pancreatitis? Results
Can Somatostatin Prevent Post-ERCP Pancreatitis? Results
Background: Acute pancreatitis is the most common complication of endoscopic retrogade cholangiopancreatography (ERCP), occurring in 1-10% of patients. Several substances have been used, with negative results, in an attempt to prevent this complication.
Methods: We performed a double-blind randomized trial in 372 consecutive patients undergoing diagnostic or therapeutic ERCP to evaluate the role of somatostatin in preventing post-ERCP pancreatitis. The first group received continuous somatostatin infusion for 12 h starting 30 min before ERCP, the second group received a bolus intravenous injection of somatostatin at the time of cannulation of the papilla, and the third group received a placebo.
Results: Two patients in each of the somatostatin groups (1.7%) and 12 patients in the placebo group (9.8%) developed pancreatitis (P < 0.05). Serum amylase levels 5 and 24 h after the procedure were lower in both groups that received somatostatin than in the placebo group (P < 0.05).
Conclusion: Somatostatin is useful in preventing post-ERCP pancreatitis. Further studies must be designed to investigate the cost-effectiveness of the drug and to determine the ideal administration route and dosage.
Acute pancreatitis is the most common complication of endoscopic retrogade cholangiopancreatography (ERCP), occurring in 1-10% of patients according to retrospective studies. Although its course is generally benign, hospitalization for several days is usually required.
Several substances have been used in an attempt to prevent this complication, mainly through inhibition of pancreatic secretion. Somatostatin has been evaluated in several trials with controversial results. It inhibits the pancreatic exocrine secretion by suppression of release of secretin and cholecystokinin. Somatostatin also reduces the intrapancreatic duct pressure by inhibiting the motility of the sphincter of Oddi. The aim of the present study was to evaluate the efficacy of natural somatostatin in preventing post-ERCP pancreatitis either as a single bolus intravenous injection or as continuous intravenous infusion.
Background: Acute pancreatitis is the most common complication of endoscopic retrogade cholangiopancreatography (ERCP), occurring in 1-10% of patients. Several substances have been used, with negative results, in an attempt to prevent this complication.
Methods: We performed a double-blind randomized trial in 372 consecutive patients undergoing diagnostic or therapeutic ERCP to evaluate the role of somatostatin in preventing post-ERCP pancreatitis. The first group received continuous somatostatin infusion for 12 h starting 30 min before ERCP, the second group received a bolus intravenous injection of somatostatin at the time of cannulation of the papilla, and the third group received a placebo.
Results: Two patients in each of the somatostatin groups (1.7%) and 12 patients in the placebo group (9.8%) developed pancreatitis (P < 0.05). Serum amylase levels 5 and 24 h after the procedure were lower in both groups that received somatostatin than in the placebo group (P < 0.05).
Conclusion: Somatostatin is useful in preventing post-ERCP pancreatitis. Further studies must be designed to investigate the cost-effectiveness of the drug and to determine the ideal administration route and dosage.
Acute pancreatitis is the most common complication of endoscopic retrogade cholangiopancreatography (ERCP), occurring in 1-10% of patients according to retrospective studies. Although its course is generally benign, hospitalization for several days is usually required.
Several substances have been used in an attempt to prevent this complication, mainly through inhibition of pancreatic secretion. Somatostatin has been evaluated in several trials with controversial results. It inhibits the pancreatic exocrine secretion by suppression of release of secretin and cholecystokinin. Somatostatin also reduces the intrapancreatic duct pressure by inhibiting the motility of the sphincter of Oddi. The aim of the present study was to evaluate the efficacy of natural somatostatin in preventing post-ERCP pancreatitis either as a single bolus intravenous injection or as continuous intravenous infusion.
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