Skip to main content
PMC home page
Gut logoLink to Gut
. 1992 Aug;33(8):1129–1133. doi: 10.1136/gut.33.8.1129

Does the somatostatin analogue octreotide protect against ERCP induced pancreatitis?

K F Binmoeller 1, A G Harris 1, R Dumas 1, C Grimaldi 1, J P Delmont 1
PMCID: PMC1379457  PMID: 1383099

Abstract

This study evaluates the effect of the long acting somatostatin analogue octreotide on biochemical and clinical parameters of endoscopic retrograde cholangiopancreatography (ERCP) induced pancreatitis. Altogether 245 patients were randomised to receive either octreotide or isotonic saline. Octreotide (100 micrograms) was administered intravenously five minutes before ERCP and subcutaneously 45 minutes after ERCP. There were no significant differences in the median serum amylase and lipase activities at baseline, eight, and 24 hours after ERCP. Five patients (2%) developed clinical pancreatitis--three in the octreotide and two in the placebo groups. Excluding patients who developed pancreatitis, 43 (18%) developed abdominal pain after ERCP--21 in the octreotide and 23 in the placebo groups. There were no significant differences in the median serum amylase and lipase values between the treatment groups. None of the 52 patients who had therapeutic interventions developed pancreatitis. This study suggests that octreotide may not protect against ERCP induced pancreatitis.

Full text

PDF
1129

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Adami G. F., Leandri R., Sarles J. C. Action de la somatostatine sur le sphincter d'Oddi du lapin "in vivo". Inter-relations somatostatine-cholécystokinine. Gastroenterol Clin Biol. 1986 Feb;10(2):108–111. [PubMed] [Google Scholar]
  2. Ashkin J. R., Lyon D. T., Shull S. D., Wagner C. I., Soloway R. D. Factors affecting delivery of bile to the duodenum in man. Gastroenterology. 1978 Mar;74(3):560–565. [PubMed] [Google Scholar]
  3. Baxter J. N., Jenkins S. A., Day D. W., Roberts N. B., Cowell D. C., Mackie C. R., Shields R. Effects of somatostatin and a long-acting somatostatin analogue on the prevention and treatment of experimentally induced acute pancreatitis in the rat. Br J Surg. 1985 May;72(5):382–385. doi: 10.1002/bjs.1800720516. [DOI] [PubMed] [Google Scholar]
  4. Bilbao M. K., Dotter C. T., Lee T. G., Katon R. M. Complications of endoscopic retrograde cholangiopancreatography (ERCP). A study of 10,000 cases. Gastroenterology. 1976 Mar;70(3):314–320. [PubMed] [Google Scholar]
  5. Binmoeller K. F., Dumas R., Harris A. G., Delmont J. P. Effect of somatostatin analog octreotide on human sphincter of Oddi. Dig Dis Sci. 1992 May;37(5):773–777. doi: 10.1007/BF01296438. [DOI] [PubMed] [Google Scholar]
  6. Bordas J. M., Toledo V., Mondelo F., Rodés J. Prevention of pancreatic reactions by bolus somatostatin administration in patients undergoing endoscopic retrograde cholangio-pancreatography and endoscopic sphincterotomy. Horm Res. 1988;29(2-3):106–108. doi: 10.1159/000180981. [DOI] [PubMed] [Google Scholar]
  7. Börsch G., Bergbauer M., Nebel W., Sabin G. Der Einfluss von Somatostatin auf die Amylasespiegel und Pankreatitisrate nach ERCP. Med Welt. 1984 Jan 27;35(4):109–112. [PubMed] [Google Scholar]
  8. Choi T. K., Mok F., Zhan W. H., Fan S. T., Lai E. C., Wong J. Somatostatin in the treatment of acute pancreatitis: a prospective randomised controlled trial. Gut. 1989 Feb;30(2):223–227. doi: 10.1136/gut.30.2.223. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Cotton P. B. ERCP. Gut. 1977 Apr;18(4):316–341. doi: 10.1136/gut.18.4.316. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Creutzfeldt W., Lembcke B., Fölsch U. R., Schleser S., Koop I. Effect of somatostatin analogue (SMS 201-995, Sandostatin) on pancreatic secretion in humans. Am J Med. 1987 May 29;82(5B):49–54. doi: 10.1016/0002-9343(87)90426-8. [DOI] [PubMed] [Google Scholar]
  11. D'Amico D., Favia G., Biasiato R., Casaccia M., Falcone F., Fersini M., Marrano D., Napolitano F., Oliviero S., Rodolico A. The use of somatostatin in acute pancreatitis--results of a multicenter trial. Hepatogastroenterology. 1990 Feb;37(1):92–98. [PubMed] [Google Scholar]
  12. Geenen J. E., Vennes J. A., Silvis S. E. Résumé of a seminar on endoscopic retrograde sphincterotomy (ERS). Gastrointest Endosc. 1981 Feb;27(1):31–38. doi: 10.1016/s0016-5107(81)73140-7. [DOI] [PubMed] [Google Scholar]
  13. Guelrud M., Mendoza S., Viera L., Gelrud D. Somatostatin prevents acute pancreatitis after pancreatic duct sphincter hydrostatic balloon dilation in patients with idiopathic recurrent pancreatitis. Gastrointest Endosc. 1991 Jan-Feb;37(1):44–47. doi: 10.1016/s0016-5107(91)70619-6. [DOI] [PubMed] [Google Scholar]
  14. Hamilton I., Lintott D. J., Rothwell J., Axon A. T. Acute pancreatitis following endoscopic retrograde cholangiopancreatography. Clin Radiol. 1983 Sep;34(5):543–546. doi: 10.1016/s0009-9260(83)80156-1. [DOI] [PubMed] [Google Scholar]
  15. Köhler E., Beglinger C., Dettwiler S., Whitehouse I., Gyr K. Effect of a new somatostatin analogue on pancreatic function in healthy volunteers. Pancreas. 1986;1(2):154–159. doi: 10.1097/00006676-198603000-00008. [DOI] [PubMed] [Google Scholar]
  16. LaFerla G., Gordon S., Archibald M., Murray W. R. Hyperamylasaemia and acute pancreatitis following endoscopic retrograde cholangiopancreatography. Pancreas. 1986;1(2):160–163. doi: 10.1097/00006676-198603000-00009. [DOI] [PubMed] [Google Scholar]
  17. Lankisch P. G., Koop H., Winckler K., Fölsch U. R., Creutzfeldt W. Somatostatin therapy of acute experimental pancreatitis. Gut. 1977 Sep;18(9):713–716. doi: 10.1136/gut.18.9.713. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Lembcke B., Creutzfeldt W., Schleser S., Ebert R., Shaw C., Koop I. Effect of the somatostatin analogue sandostatin (SMS 201-995) on gastrointestinal, pancreatic and biliary function and hormone release in normal men. Digestion. 1987;36(2):108–124. doi: 10.1159/000199408. [DOI] [PubMed] [Google Scholar]
  19. Løtveit T., Larsen S., Grønseth K., Osnes M. The probability of pancreatitis after pancreatic parenchymatography with a non-ionic contrast medium. A sequentially designed clinical trial. Scand J Gastroenterol. 1987 Jan;22(1):111–116. doi: 10.3109/00365528708991866. [DOI] [PubMed] [Google Scholar]
  20. Mann N. S., Mauch M. J. Inhibitory effect of cycloheximide, somatostatin and 5-azacytidine on acute experimental pancreatitis. Am J Proctol Gastroenterol Colon Rectal Surg. 1981 Jul;32(7):24–32. [PubMed] [Google Scholar]
  21. Muller E. L., Grace P. A., Conter R. L., Roslyn J. J., Pitt H. A. Influence of motilin and cholecystokinin on sphincter of Oddi and duodenal mobility. Am J Physiol. 1987 Nov;253(5 Pt 1):G679–G683. doi: 10.1152/ajpgi.1987.253.5.G679. [DOI] [PubMed] [Google Scholar]
  22. Odes H. S., Novis B. N., Barbezat G. O., Bank S. Effect of calcitonin on the serum amylase levels after endoscopic retrograde cholangiopancreatography. Digestion. 1977;16(1-2):180–184. doi: 10.1159/000198070. [DOI] [PubMed] [Google Scholar]
  23. Sarles J. C., Bidart J. M., Devaux M. A., Echinard C., Castagnini A. Action of cholecystokinin and caerulein on the rabbit sphincter of Oddi. Digestion. 1976;14(5-6):415–423. doi: 10.1159/000197965. [DOI] [PubMed] [Google Scholar]
  24. Schwedes U., Althoff P. H., Klempa I., Leuschner U., Mothes L., Raptis S., Wdowinski J., Usadel K. H. Effect of somatostatin on bile-induced acute hemorrhagic pancreatitis in the dog. Horm Metab Res. 1979 Dec;11(12):655–661. doi: 10.1055/s-0028-1092793. [DOI] [PubMed] [Google Scholar]
  25. Silvis S. E., Vennes J. A. The role of glucagon in endoscopic cholangiopancreatography. Gastrointest Endosc. 1975 May;21(4):162–163. doi: 10.1016/s0016-5107(75)73837-3. [DOI] [PubMed] [Google Scholar]
  26. Skude G., Wehlin L., Maruyama T., Ariyama J. Hyperamylasaemia after duodenoscopy and retrograde cholangiopancreatography. Gut. 1976 Feb;17(2):127–132. doi: 10.1136/gut.17.2.127. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Toouli J. Sphincter of Oddi motility. Br J Surg. 1984 Apr;71(4):251–256. doi: 10.1002/bjs.1800710402. [DOI] [PubMed] [Google Scholar]
  28. Tulassay Z., Papp J., Korányi L., Szathmári M., Tamás G., Jr Die Wirkung von Somatostatin auf Stoffwechselveränderungen nach ERCP. Wien Klin Wochenschr. 1982 May 14;94(10):261–265. [PubMed] [Google Scholar]
  29. Tulassay Z., Papp J. The effect of long-acting somatostatin analogue on enzyme changes after endoscopic pancreatography. Gastrointest Endosc. 1991 Jan-Feb;37(1):48–50. doi: 10.1016/s0016-5107(91)70620-2. [DOI] [PubMed] [Google Scholar]
  30. Tydén G., Nyberg B., Sonnenfeld T., Thulin L. Effect of somatostatin on hyperamylasemia following endoscopic pancreatography. Acta Chir Scand Suppl. 1986;530:43–45. [PubMed] [Google Scholar]

Articles from Gut are provided here courtesy of BMJ Publishing Group

RESOURCES