Effect of native somatostatin on Sphincter of Oddi motility in patients with acute recurrent pancreatitis. A pilot study with Ultrasound-Secretin test.
BACKGROUND
The effect of native somatostatin on Sphincter of Oddi motility still remains controversial. Sphincter of Oddi inhibition was demonstrated at manometry in patients in the acute phase of alcoholic pancreatitis. Other investigators showed marked somatostatin-induced impairment of bile flow by hepato-biliary scintigraphy.


OBJECTIVE
Aim of the study was to determine the effects of therapeutical doses of exogenous somatostatin on Sphincter of Oddi motility.


METHODS
We studied eight patients (two men, six women, age 18-42), in the quiescent phase of idiopathic recurrent pancreatitis. We directly studied Sphincter of Oddi motility by perendoscopic manometry and, indirectly, secretin-stimulated pancreatic juice outflow by Ultrasound-Secretin test. The two tests were repeated before and after somatostatin infusion.


RESULTS
Manometry was performed in two patients. After 250 microg somatostatin bolus the sphincter showed an increase of motor activity. At Ultrasound-Secretin test mean diameters were significantly larger at 40-60 min evaluation intervals during 250 microg/h somatostatin infusion as compared to saline infusion, showing a delayed pancreatic duct emptying.


CONCLUSIONS
Acute administration of somatostatin seems to induce an excitatory effect on Sphincter of Oddi motility, with impaired pancreatic outflow in patients in the quiescent phase of recurrent pancreatitis.
Department of Biomedical and Surgical Sciences, University of Verona, Verona, Italy. vincenzo.difrancesco@univr.it
V
V
Di Francesco
G
G
Angelini
E
E
Zoico
M
M
Zamboni
L
L
Frulloni
G
G
Cavallini
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D005260:Female; D005769:Gastrointestinal Motility / Q000187:drug effects* / Q000502:physiology; D006728:Hormones / Q000494:pharmacology*; D006801:Humans; D008297:Male; D008365:Manometry; D010183:Pancreatic Ducts / Q000000981:diagnostic imaging / Q000503:physiopathology; D010195:Pancreatitis / Q000503:physiopathology*; D010865:Pilot Projects; D012008:Recurrence; D012633:Secretin / Q000494:pharmacology; D013004:Somatostatin / Q000494:pharmacology*; D009803:Sphincter of Oddi / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000502:physiology; D014463:Ultrasonography
D006728:Hormones; D012633:Secretin; D013004:Somatostatin