Since the introduction of endoscopic retrograde cholangiopancreatology (ERCP), pancreatitis has become a common complication of this procedure.
Octreotide is an inhibitor of pancreatic enzyme secretions.
Several studies have evaluated the effect of octreotide on the incidence of clinical pancreatitis after ERCP, but with different results.
Dr Zhao-Shen Li and colleagues from China determined the efficacy of octreotide for the prevention of post-ERCP pancreatitis and hyperamylasemia.
Patients with scheduled ERCP were randomized to receive either octreotide via intramuscular injection or a placebo.
|Acute pancreatitis occurred in 2% with octreotide|
|American Jjournal of Gastroenterology|
The investigators conducted the study in 12 digestive endoscopic units.
The team randomized 414 patients to octreotide in Group 1, and 418 controls to Group 2.
For patients in Group 1, 0.3 mg octreotide was dissolved in 500 mL of 0.9% saline solution and administered by continuous intravenous infusion.
The infusion was given beginning 1 hour before endoscopic examination and continued for 6 hours thereafter.
The team injected 0.1 mg of octreotide subcutaneously at 6 and 12 hours after the intravenous injection was stopped.
The investigative team gave patients in Group 2 a placebo intravenously.
The end point was the development of acute pancreatitis.
The investigators found that the overall incidence of acute pancreatitis was 4%.
Acute pancreatitis occurred in 2% in the octreotide group and 5% in the control group.
The investigative team noted that the overall incidence of hyperamylasemia was 15%.
Hyperamylasemia was found in 12% in the octreotide group, and in 18% of the control group.
The investigators found no side effects.
Dr Li's team comments, “The results indicate that octreotide can prevent post-ERCP pancreatitis and hyperamylasemia.”