The effect of octreotide on the prevention of acute pancreatitis and hyperamylasemia after diagnostic and therapeutic ERCP.

BACKGROUND/AIMS: Acute pancreatitis is a serious complication of diagnostic and therapeutic Endoscopic Retrograde Cholangiopancreatography (ERCP). In addition, serum pancreatic enzymes increase without symptoms in about 40-50% of patients undergoing these endoscopic procedures. In order to evaluate the efficacy of octreotide in the prevention of these complications, we performed this randomised, prospective study.

METHODOLOGY

We studied 73 patients (31 males, 42 females), mean age 63.3 +/- 12.9 years (range 28-87 yrs). The patients were randomly allocated into two groups (A and B). Group A (37 patients) was given 0.1 mg of octreotide subcutaneously 30 min before and 8 and 16 hours after the procedure, and group B (36 patients) was given a placebo. Serum amylase was measured 30 min before and 3 and 6 hrs after ERCP. All patients were subjected to ultrasonography for signs of pancreatic inflammation. There was no statistically significant difference between the two groups concerning age, sex and indication for ERCP. Endoscopic sphincterotomy (ES) was performed in 14 patients of group A and 10 patients of group B.

RESULTS

There were 4 cases of acute pancreatitis in each group and the mean serum amylase at 3 and 6 hrs was comparable (494/676 and 429/582 IU/L, respectively). In comparing patients who were subjected to either diagnostic or therapeutic ERCP, there was no statistically significant difference concerning episodes of acute pancreatitis and the level of serum amylase.

CONCLUSION

Octreotide does not seem to prevent acute pancreatitis and hyperamylasaemia after diagnostic and therapeutic ERCP.