Can somatostatin prevent post-ERCP pancreatitis? Results of a randomized controlled trial.
BACKGROUND
Acute pancreatitis is the most common complication of endoscopic retrograde 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).


CONCLUSIONS
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.
Arvanitidis
Dimitrios
D
Department of Gastroenterology, 251 Hellenic Air Force and Veterans General Hospital, Athens, Greece.
Anagnostopoulos
George K
GK
Giannopoulos
Dimitrios
D
Pantes
Athanasios
A
Agaritsi
Roxanne
R
Margantinis
George
G
Tsiakos
Stavros
S
Sakorafas
George
G
Kostopoulos
Panagiotis
P
D000368:Aged; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000209:etiology / Q000517:prevention & control*; D013004:Somatostatin / Q000008:administration & dosage*
D013004:Somatostatin