It is unclear whether post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis can be prevented by administering either somatostatin or gabexate mesylate.
In this study, physicians from Italy assessed the efficacy of a 6.5-hour infusion of somatostatin or gabexate mesylate in preventing ERCP-related complications.
The team randomly assigned 1127 patients undergoing ERCP to intravenous administration of either somatostatin, gabexate mesylate, or placebo.
The drug infusion started 30 minutes before and continued for 6 hours after endoscopy.
The physicians clinically evaluated all patients.
|3 pancreatic injections were associated with post-ERCP pancreatitis.|
|Clinical Gastroenterology and Hepatology|
They also measured serum amylase levels at 4, 24, and 48 hours after endoscopy.
The team did not identify any significant differences in the incidence of pancreatitis, hyperamylasemia, or abdominal pain between the 3 groups.
However, they determined that a Freeman score of greater than 1, and 3 pancreatic injections were significantly associated with post-ERCP pancreatitis.
Dr AngeloAndriulli's team concluded, "Long-term (6.5-hr) administration of either somatostatin or gabexate mesylate is ineffective for the prevention of post-ERCP pancreatitis".
"Pancreatic injury seems to be related to difficulty in common bile duct access".