Kisli E, Baser M, Aydin M, Guler O
Department of General Surgery, School of Medicine, Yuzuncu Yil University, Van, Turkey.
Hepatogastroenterology. 2007 Jan-Feb;54(73):250-3.
BACKGROUND/AIMS: To evaluate the effectiveness of a single administration of intravenous octreotide infusion in preventing post-ERCP pancreatitis and progressing hyperamylasemia.
One hundred and twenty (71 female, 59 male) patients who had been diagnosed with pancreaticobiliary pathology were included in this study. 100 microgram (0.1 mg) octreotide diluted in 60 mL normal saline solution administered intravenously 60 minutes prior to the procedure and continued during the procedure and after the procedure. Placebo was given in 87 patients. Patients were assessed clinically and serum amylase level was also measured before the procedure and 3, 12, and 24 hours after the procedure. We define clinical pancreatitis as serum amylase level greater than 4-5 times in conjunction with clinical assessment.
Hyperamylasemia was assessed in 14 of 33 (42.4%) administered octreotide patients. Clinical findings of pancreatitis were observed in 5 of these 14 (11.5%) patients. Hyperamylasemia was also assessed in 41 of 87 (47.1%) administered placebo patients. Clinical findings of pancreatitis were observed in 10 of these 41 (11.5) patients. There were no significant differences between the groups, statistically (p > 0.05) (Pearson chi-square test).
The results of this trial indicate that a single administration of intravenous octreotide infusion does not prevent ERCP-induced pancreatitis and effect serum amylase level.
背景/目的:评估单次静脉注射奥曲肽预防内镜逆行胰胆管造影术(ERCP)后胰腺炎及高淀粉酶血症进展的有效性。
本研究纳入120例(71例女性,59例男性)被诊断为胰胆疾病的患者。在手术前60分钟静脉注射将100微克(0.1毫克)奥曲肽稀释于60毫升生理盐水中,并在手术过程中和手术后持续给药。87例患者给予安慰剂。在手术前以及手术后3、12和24小时对患者进行临床评估并测量血清淀粉酶水平。我们将临床胰腺炎定义为血清淀粉酶水平高于4 - 5倍并伴有临床评估。
在33例接受奥曲肽治疗的患者中,14例(42.4%)出现高淀粉酶血症。在这14例患者中,5例(11.5%)观察到胰腺炎的临床症状。在87例接受安慰剂治疗的患者中,41例(47.1%)出现高淀粉酶血症。在这41例患者中,10例(11.5%)观察到胰腺炎的临床症状。两组之间无统计学显著差异(p>0.05)(Pearson卡方检验)。
该试验结果表明,单次静脉注射奥曲肽不能预防ERCP诱导的胰腺炎,也不影响血清淀粉酶水平。