Abstract
Acute pancreatitis is a serious complication of endoscopic retrograde cholangiopancreatography
(ERCP) and endoscopic sphincterotomy (EST). In addition, serum pancreatic enzymes
increase without clinical symptoms in about 40-50 % of patients undergoing these endoscopic
procedures. We evaluated the potential of octreotide, a long-acting somatostatin analogue,
to prevent these complications in patients who underwent EST for choledocholithiasis.
151 patients were randomly allocated to two groups (A and B). Group A was given 0.1 mg
of octreotide subcutaneously 120 and 30 min before EST and four hours after; group
B was given a placebo. Serum amylases (normal range 20-220 IU/1) were measured before
premedication and 4, 24, and 48 hours after the end of endoscopy. After EST, the increase
in the mean serum amylase was greater in the control group, but the difference was
statistically significant only at the 48-hour measurement. There were five cases of
acute pancreatitis in each group, with a trend (but not statistically significant)
toward less severe pancreatitis in the treated group. In the control group, one patient
with acute pancreatitis died. In conclusion, octreotide does not seem to prevent acute
post-EST pancreatitis.
