Online citations, reference lists, and bibliographies.
Please confirm you are human
(Sign Up for free to never see this)
← Back to Search

Intravenous Bolus Somatostatin After Diagnostic Cholangiopancreatography Reduces The Incidence Of Pancreatitis Associated With Therapeutic Endoscopic Retrograde Cholangiopancreatography Procedures: A Randomised Controlled Trial

R. Poon, C. Yeung, C-L. Liu, C-M Lam, W-K Yuen, C. Lo, A. Tang, St Fan
Published 2003 · Medicine

Save to my Library
Download PDF
Analyze on Scholarcy
Share
Background: Previous studies suggested that somatostatin given before endoscopic retrograde cholangiopancreatography (ERCP) may reduce the incidence of post-ERCP pancreatitis. However, the routine use of somatostatin in all patients undergoing ERCP is not likely to be cost effective. This study evaluated whether intravenous bolus somatostatin given after diagnostic cholangiopancreatography could reduce the incidence of pancreatitis in a group of patients undergoing therapeutic ERCP procedures. Methods: In a randomised, double blind, controlled trial, the effect of intravenous bolus somatostatin 250 μg given immediately after diagnostic cholangiopancreatography was compared with that of placebo in patients who required endoscopic sphincterotomy or other therapeutic procedures. The primary end point was the incidence of post-ERCP clinical pancreatitis, and a secondary end point was the incidence of hyperamylasemia. Results: A total of 270 patients were randomised. The somatostatin group (n = 135) and the placebo group (n = 135) were comparable in age, sex, indications for treatment, and types of procedure. The frequencies of clinical pancreatitis (4.4% v 13.3%; p = 0.010) and hyperamylasemia (26.0% v 38.5%; p = 0.036) were both significantly lower in the somatostatin group compared with the placebo group. Conclusions: A single dose of intravenous bolus somatostatin, given immediately after diagnostic cholangiopancreatography, is effective in reducing the incidence of pancreatitis after therapeutic ERCP. This novel approach of administering prophylactic somatostatin may offer a cost effective prophylaxis for post-ERCP pancreatitis.
This paper references
Early recognition of post-ERCP pancreatitis by clinical assessment and serum pancreatic enzymes.
K. Gottlieb (1996)
10.1016/S0016-5107(02)70112-0
Risk factors for complications after performance of ERCP.
J. Vandervoort (2002)
10.1016/S0016-5107(99)70385-8
Same-day discharge after endoscopic biliary sphincterotomy: observations from a prospective multicenter complication study. The Multicenter Endoscopic Sphincterotomy (MESH) Study Group.
M. Freeman (1999)
pancreatitis: a prospective, double-blind randomized study. Gastrointest Endosc 2002;56:202–8
RT Poon (1999)
10.1007/BF01296438
Effect of somatostatin analog octreotide on human sphincter of Oddi
K. Binmoeller (2005)
endoscopic biliary sphincterotomy: observations from a prospective multicenter complication study. The Multicenter Endoscopic Sphincterotomy (MESH) Study Group. Gastrointest Endosc 1999;49:580–6
KY Ho (1999)
Endoscopic papillo-sphincterotomy: Prevention of pancreatic reaction by somatostatin
P. Testoni (1988)
10.1016/S0016-5107(98)70318-9
Effects of bolus somatostatin in preventing pancreatitis after endoscopic pancreatography: results of a randomized study.
J. Bordas (1998)
10.1055/S-2001-16520
A prospective, randomized, placebo-controlled trial of prednisone and allopurinol in the prevention of ERCP-induced pancreatitis.
A. Budzyńska (2001)
10.1016/S0002-9270(01)02655-7
A randomized, double blind study of interleukin 10 for the prevention of ERCP-induced pancreatitis
J. Dumot (2001)
Somatostatin inhibits sphincter of Oddi motility Interleukin-10 reduces the incidence of pancreatitis after therapeutic endoscopic retrograde cholangiopancreatography
Sa Ahrendt (1990)
10.1046/j.1365-2036.1998.00295.x
Meta‐analysis of somatostatin, octreotide and gabexate mesilate in the therapy of acute pancreatitis
Andriulli (1998)
10.1016/S0016-5107(91)70740-2
Endoscopic sphincterotomy complications and their management: an attempt at consensus.
P. Cotton (1991)
10.1097/00006676-199105000-00013
ERCP‐ and Endoscopic Sphincterotomy‐Induced Pancreatitis
S. Sherman (1991)
10.1016/S0016-5107(02)70178-8
Nifedipine for prevention of post-ERCP pancreatitis: a prospective, double-blind randomized study.
F. Prat (2002)
Antisecretory agents for prevention of post-ERCP pancreatitis: rationale for use and clinical results.
R. Poon (2003)
10.1067/MGE.2001.117550
Risk factors for post-ERCP pancreatitis: a prospective, multicenter study.
M. Freeman (2001)
cytokine induced acute phase response in acute pancreatitis. Gut 1997;40:80–5
K Karalis (2000)
10.1016/S0016-5107(94)70204-7
Post-ERCP pancreatitis: randomized, prospective study comparing a low- and high-osmolality contrast agent.
S. Sherman (1994)
10.1016/S0016-5107(99)70386-X
Features that may predict hospital admission following outpatient therapeutic ERCP.
K. Ho (1999)
10.1111/j.1572-0241.1998.061_c.x
Pretreatment With Methylprednisolone to Prevent Ercp-Induced Pancreatitis: A Randomized, Multicenter, Placebo-Controlled Clinical Trial
J. Dumot (1998)
Gabexate for the prevention of pancreatic damage related to endoscopic retrograde cholangiopancreatography.
J. Schneider (1997)
10.1136/gut.33.8.1129
Does the somatostatin analogue octreotide protect against ERCP induced pancreatitis?
K. Binmoeller (1992)
10.1016/S0016-5107(00)70377-4
Pharmacologic treatment can prevent pancreatic injury after ERCP: a meta-analysis.
A. Andriulli (2000)
10.1046/j.1365-2036.2001.01015.x
Octreotide 24‐h prophylaxis in patients at high risk for post‐ERCP pancreatitis: results of a multicenter, randomized, controlled trial
P. Testoni (2001)
patients with idiopathic recurrent pancreatitis
B Persson (1992)
A prospective, randomized, placebocontrolled trial of prednisone and allopurinol in the prevention of ERCPinduced pancreatitis. Endoscopy 2001;33:766–72
A Budzynska (2001)
A prospective, randomized, placebocontrolled trial of prednisone and allopurinol in the prevention of ERCPinduced pancreatitis
A Budzynska (2001)
Octreotide 24h prophylaxis in patients at high risk for postERCP pancreatitis : results of a multicenter , randomized , controlled trial
PA Testoni (2001)
10.1046/j.1440-1746.2001.02499.x
Effects and mechanisms of somatostatin analogs on apoptosis of pancreatic acinar cells in acute pancreatitis in mice
Y. Yuan (2001)
10.1016/S0016-5107(99)70387-1
Prophylactic effect of somatostatin on post-ERCP pancreatitis: a randomized controlled trial.
R. Poon (1999)
10.1016/S0016-5107(91)70619-6
Somatostatin prevents acute pancreatitis after pancreatic duct sphincter hydrostatic balloon dilation in patients with idiopathic recurrent pancreatitis.
M. Guelrud (1991)
10.1016/0016-5085(91)90735-4
Complications of endoscopic sphincterotomy. A prospective series with emphasis on the increased risk associated with sphincter of Oddi dysfunction and nondilated bile ducts.
S. Sherman (1991)
10.1136/gut.40.1.80
Post-ERP pancreatitis as a model for cytokine induced acute phase response in acute pancreatitis.
H. Messmann (1997)
10.1053/gast.2001.26047
Interleukin 10 reduces the incidence of pancreatitis after therapeutic endoscopic retrograde cholangiopancreatography.
J. Deviére (2001)
10.1056/NEJM199609263351301
Complications of endoscopic biliary sphincterotomy.
M. Freeman (1996)
10.1172/JCI117193
Somatostatin analogues suppress the inflammatory reaction in vivo.
K. Karalis (1994)
10.1053/GAST.2001.21172
Interleukin 10 reduces the incidence of pancreatitis after therapeutic endoscopic retrograde cholangiopancreatography.
J. Devière (2001)
on apoptosis of pancreatic acinar cells in acute pancreatitis in mice
A Andriulli (1998)
Can somatostatin prevent injection pancreatitis after ERCP?
B. Persson (1992)
10.1016/S0016-5107(95)70128-1
A comparison of nonionic versus ionic contrast media: results of a prospective, multicenter study. Midwest Pancreaticobiliary Study Group.
G. K. Johnson (1995)
10.1111/j.1572-0241.2001.04092.x
A randomized, double blind study of interleukin 10 for the prevention of ERCP-induced pancreatitis
J. Dumot (2001)
Somatostatin inhibits sphincter of Oddi motility
SA Ahrendt (1990)



This paper is referenced by
10.1038/nrgastro.2012.3
Endoscopic complications—avoidance and management
D. Bléro (2012)
10.3748/WJG.V11.I15.2319
Nitroester drug's effects and their antagonistic effects against morphine on human sphincter of Oddi motility.
S. Wu (2005)
10.1016/J.BEEM.2004.08.005
Clinical endocrinology and metabolism. The somatostatin neuroendocrine system: physiology and clinical relevance in gastrointestinal and pancreatic disorders.
M. Low (2004)
10.1016/J.GIE.2006.03.934
Twenty-four hour prophylaxis with increased dosage of octreotide reduces the incidence of post-ERCP pancreatitis.
K. Thomopoulos (2006)
10.1097/00004836-200609000-00013
Endoscopic Retrograde Cholangiopancreatography-induced Acute Pancreatitis Often has a Benign Outcome
V. Bhatia (2006)
10.1016/J.GIE.2005.11.060
A prospective, randomized, placebo-controlled trial of transdermal glyceryl trinitrate in ERCP: effects on technical success and post-ERCP pancreatitis.
A. Kaffes (2006)
10.1007/s00535-010-0234-4
Meta-analysis: somatostatin or its long-acting analogue, octreotide, for prophylaxis against post-ERCP pancreatitis
F. Omata (2010)
10.1016/S0377-1237(05)80001-2
What is New in Acute Pancreatitis?
V. Vij (2005)
10.3389/fphar.2016.00489
Role of Somatostatin in Preventing Post-endoscopic Retrograde Cholangiopancreatography (ERCP) Pancreatitis: An Update Meta-analysis
J. Hu (2016)
10.1002/bjs.4705
Scientific surgery
(2004)
10.1002/9781118321386.CH126
Diagnostic and Interventional Endoscopic Retrograde Cholangiopancreatography
George Webster (2012)
10.1007/s00535-008-2272-8
Epinephrine sprayed on the papilla for prevention of post-ERCP pancreatitis
Mitsunobu Matsushita (2008)
10.3748/WJG.14.2968
Pharmacological approach to acute pancreatitis.
U. Bang (2008)
Post-procedural Administration of Nafamostat Mesilate Showed a Similar Preventive effect Against Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis Compared with Pre-procedural Administration for Patients with Pancreatobiliary Diseases Who underwent ERCP .-A Prospective Double-blind Ra
Kei Ito (2016)
10.1111/den.12816
Rectal NSAIDs in the prevention of post‐endoscopic retrograde cholangiopancreatography pancreatitis in unselected patients: Systematic review and meta‐analysis
Chongrong Shen (2017)
10.3748/WJG.V13.I28.3855
Relationship between post-ERCP pancreatitis and the change of serum amylase level after the procedure.
K. Ito (2007)
10.1016/S0140-6736(16)30310-5
Routine pre-procedural rectal indometacin versus selective post-procedural rectal indometacin to prevent pancreatitis in patients undergoing endoscopic retrograde cholangiopancreatography: a multicentre, single-blinded, randomised controlled trial
H. Luo (2016)
10.1016/S1726-4901(09)70023-1
Somatostatin for prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis: a never-ending story?
Chun-Chia Chen (2009)
10.4253/wjge.v2.i5.165
Endoscopic retrograde cholangiopancreatography associated pancreatitis: A 15-year review.
Kevin E. Woods (2010)
10.1055/s-0032-1309840
Endoscopic treatment of chronic pancreatitis: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline.
J-M Dumonceau (2012)
10.1016/J.GIE.2006.07.004
Facts and fiction in the pharmacologic prevention of post-ERCP pancreatitis: a never-ending story.
P. Testoni (2006)
ROUND TABLE Antiproteases in Preventing Post-ERCP Acute Pancreatitis
T. Tsujino (2007)
10.4253/wjge.v4.i11.506
Losartan to prevent hyperenzymemia after endoscopic retrograde cholangiopan-creatography: A randomized clinical trial.
T. Bexelius (2012)
10.1097/MED.0b013e32833463ed
Somatostatin and the gastrointestinal tract
V. Corleto (2010)
10.1159/000368812
Direct Spraying of Shakuyakukanzoto onto the Duodenal Papilla: A Novel Method for Preventing Pancreatitis following Endoscopic Retrograde Cholangiopancreatography
H. Fujinami (2015)
10.1016/j.gie.2014.06.045
Incidence, severity, and mortality of post-ERCP pancreatitis: a systematic review by using randomized, controlled trials.
B. Kochar (2015)
10.1055/s-0029-1244208
European Society of Gastrointestinal Endoscopy (ESGE) Guideline: prophylaxis of post-ERCP pancreatitis.
J-M Dumonceau (2010)
10.1159/000136564
Ätiopathogenese und Prävention der iatrogenen Pankreatitis
Jörg Ringel (2008)
10.1038/NCPGASTHEP0996
Should somatostatin or gabexate be given for prophylaxis of pancreatitis in patients undergoing ERCP?
G. Papachristou (2008)
10.1111/j.1440-1746.2011.06718.x
Prevention of post‐endoscopic retrograde cholangiopancreatography pancreatitis by epinephrine sprayed on the papilla
L. Xu (2011)
10.1016/B978-1-4377-1454-8.00036-9
Chapter 36 – Stones in the bile duct: Endoscopic and percutaneous approaches
S. Puli (2012)
10.1007/s00464-004-8130-8
A stone extraction facilitation device to achieve an improved technique for performing LCBDE
D. Wenner (2004)
See more
Semantic Scholar Logo Some data provided by SemanticScholar