Arvanitidis Dimitrios, Anagnostopoulos George K, Giannopoulos Dimitrios, Pantes Athanasios, Agaritsi Roxanne, Margantinis George, Tsiakos Stavros, Sakorafas George, Kostopoulos Panagiotis
Department of Gastroenterology, 251 Hellenic Air Force and Veterans General Hospital, Athens, Greece.
J Gastroenterol Hepatol. 2004 Mar;19(3):278-82. doi: 10.1111/j.1440-1746.2003.03297.x.
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.
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.
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).
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.
急性胰腺炎是内镜逆行胰胆管造影术（ERCP）最常见的并发症，发生率为1%至10%。为预防该并发症，人们尝试使用了多种物质，但结果均为阴性。
我们对372例连续接受诊断性或治疗性ERCP的患者进行了一项双盲随机试验，以评估生长抑素在预防ERCP术后胰腺炎中的作用。第一组在ERCP前30分钟开始连续输注生长抑素12小时，第二组在乳头插管时静脉推注生长抑素，第三组接受安慰剂。
生长抑素组各有2例患者（1.7%）发生胰腺炎，安慰剂组有12例患者（9.8%）发生胰腺炎（P<0.05）。接受生长抑素治疗的两组患者术后5小时和24小时的血清淀粉酶水平均低于安慰剂组（P<0.05）。
生长抑素有助于预防ERCP术后胰腺炎。必须开展进一步研究，以调查该药物的成本效益，并确定理想的给药途径和剂量。
