Can somatostatin prevent injection pancreatitis after ERCP?
In a double-blind randomized study, 30 patients received somatostatin infusion during ERCP and 30 patients placebo with the aim of evaluating whether somatostatin can reduce the incidence of injection pancreatitis. S-amylase, U-amylase and S-lipase were evaluated before, during and after (up to 48 hours) ERCP. C-peptide was also determined as a marker of the function of the endocrine pancreas. While no statistically significant effect of somatostatin in terms of amylase and lipase was to be found, somatostatin did significantly decrease c-peptide levels in plasma, indicating that the peptide inhibited beta-cell secretion. About 40% of patients in the somatostatin group and about 50% in the placebo group showed signs of injection pancreatitis (elevated levels of enzymes) and in both groups there are patients with clinically apparent pancreatitis.
Persson
B
B
Department of Diagnostic Radiology, Karolinska Hospital, Stockholm, Sweden.
Slezak
P
P
Efendic
S
S
Häggmark
A
A
D000368:Aged; D000681:Amylases / Q000097:blood / Q000187:drug effects; D002096:C-Peptide / Q000097:blood / Q000187:drug effects; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007267:Injections / Q000009:adverse effects; D008049:Lipase / Q000097:blood / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000097:blood / Q000209:etiology / Q000517:prevention & control*; D013004:Somatostatin / Q000627:therapeutic use*
D002096:C-Peptide; D013004:Somatostatin; D008049:Lipase; D000681:Amylases