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Can somatostatin prevent post‐ERCP pancreatitis? Results of a randomized controlled trial
Author(s) -
ARVANITIDIS DIMITRIOS,
ANAGNOSTOPOULOS GEORGE K,
GIANNOPOULOS DIMITRIOS,
PANTES ATHANASIOS,
AGARITSI ROXANNE,
MARGANTINIS GEORGE,
TSIAKOS STAVROS,
SAKORAFAS GEORGE,
KOSTOPOULOS PANAGIOTIS
Publication year - 2004
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.2003.03297.x
Subject(s) - medicine , pancreatitis , somatostatin , endoscopic retrograde cholangiopancreatography , placebo , complication , randomized controlled trial , acute pancreatitis , gastroenterology , bolus (digestion) , surgery , pancreatic disease , octreotide , anesthesia , pancreas , pathology , alternative medicine
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. © 2004 Blackwell Publishing Asia Pty Ltd