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Is prophylactic somatostatin effective to prevent post-endoscopic retrograde cholangiopancreatography pancreatitis or hyperamylasemia? A randomized, placebo-controlled pilot trial.
Chin Med J (Engl). 2013 Jul; 126(13):2403-8.CM

Abstract

BACKGROUND

Effects of prophylactic somatostatin on post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) and hyperamylasemia remain inconclusive. This study aimed to examine whether high-dose, long-term continuous infusion of somatostatin can reduce the incidence of PEP and post-ERCP hyperamylasemia.

METHODS

This was a randomized, placebo-controlled pilot trial. One hundred and twenty-four patients scheduled for ERCP from December 2008 to May 2010 randomly received one of the following three interventions: pre-ERCP somatostatin (0.5 mg/h for 24 hours, starting 1 hour prior to ERCP; n = 36), post-ERCP somatostatin (0.5 mg/h for 24 hours, starting 1 hour after ERCP; n = 47), or placebo (saline for 24 hours, starting 1 hour prior to ERCP; n = 41). Serum amylase and lipase concentrations were measured 1 to 3 hours prior to ERCP and 6, 24, and 48 hours after ERCP.

RESULTS

The three groups did not differ in age, gender, medical history, or ERCP procedure (catheterization using contrast or guidewire, pancreatic duct visualization, procedure time, or procedure type). The rate of PEP was 13.7% (17/124) in the overall study sample and 16.7% (6/36), 10.6% (5/47), and 14.6% (6/41) in the pre-ERCP somatostatin, post-ERCP somatostatin, and placebo groups, respectively (P = 0.715). The rate of post-ERCP hyperamylasemia was 19.4% (7/36), 21.3% (10/47), and 46.3% (19/41) in the pre-ERCP somatostatin, post-ERCP somatostatin, and placebo groups, respectively (P = 0.011).

CONCLUSIONS

High-dose, long-term continuous infusion (0.5 mg/h for 24 hours) of somatostatin, performed as either a pre- or post-ERCP, can reduce the incidence of hyperamylasemia, but not PEP.

Authors+Show Affiliations

Department of Gastroenterology and Hepatology, Chinese People's Liberation Army General Hospital, Beijing 100853, China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

23823808

Citation

Wang, Zi-kai, et al. "Is Prophylactic Somatostatin Effective to Prevent Post-endoscopic Retrograde Cholangiopancreatography Pancreatitis or Hyperamylasemia? a Randomized, Placebo-controlled Pilot Trial." Chinese Medical Journal, vol. 126, no. 13, 2013, pp. 2403-8.
Wang ZK, Yang YS, Cai FC, et al. Is prophylactic somatostatin effective to prevent post-endoscopic retrograde cholangiopancreatography pancreatitis or hyperamylasemia? A randomized, placebo-controlled pilot trial. Chin Med J (Engl). 2013;126(13):2403-8.
Wang, Z. K., Yang, Y. S., Cai, F. C., Wang, Y. H., Shi, X. L., Ding, C., & Li, W. (2013). Is prophylactic somatostatin effective to prevent post-endoscopic retrograde cholangiopancreatography pancreatitis or hyperamylasemia? A randomized, placebo-controlled pilot trial. Chinese Medical Journal, 126(13), 2403-8.
Wang ZK, et al. Is Prophylactic Somatostatin Effective to Prevent Post-endoscopic Retrograde Cholangiopancreatography Pancreatitis or Hyperamylasemia? a Randomized, Placebo-controlled Pilot Trial. Chin Med J (Engl). 2013;126(13):2403-8. PubMed PMID: 23823808.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Is prophylactic somatostatin effective to prevent post-endoscopic retrograde cholangiopancreatography pancreatitis or hyperamylasemia? A randomized, placebo-controlled pilot trial. AU - Wang,Zi-kai, AU - Yang,Yun-sheng, AU - Cai,Feng-chun, AU - Wang,Yong-hua, AU - Shi,Xiao-lin, AU - Ding,Chen, AU - Li,Wen, PY - 2013/7/5/entrez PY - 2013/7/5/pubmed PY - 2014/1/24/medline SP - 2403 EP - 8 JF - Chinese medical journal JO - Chin Med J (Engl) VL - 126 IS - 13 N2 - BACKGROUND: Effects of prophylactic somatostatin on post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) and hyperamylasemia remain inconclusive. This study aimed to examine whether high-dose, long-term continuous infusion of somatostatin can reduce the incidence of PEP and post-ERCP hyperamylasemia. METHODS: This was a randomized, placebo-controlled pilot trial. One hundred and twenty-four patients scheduled for ERCP from December 2008 to May 2010 randomly received one of the following three interventions: pre-ERCP somatostatin (0.5 mg/h for 24 hours, starting 1 hour prior to ERCP; n = 36), post-ERCP somatostatin (0.5 mg/h for 24 hours, starting 1 hour after ERCP; n = 47), or placebo (saline for 24 hours, starting 1 hour prior to ERCP; n = 41). Serum amylase and lipase concentrations were measured 1 to 3 hours prior to ERCP and 6, 24, and 48 hours after ERCP. RESULTS: The three groups did not differ in age, gender, medical history, or ERCP procedure (catheterization using contrast or guidewire, pancreatic duct visualization, procedure time, or procedure type). The rate of PEP was 13.7% (17/124) in the overall study sample and 16.7% (6/36), 10.6% (5/47), and 14.6% (6/41) in the pre-ERCP somatostatin, post-ERCP somatostatin, and placebo groups, respectively (P = 0.715). The rate of post-ERCP hyperamylasemia was 19.4% (7/36), 21.3% (10/47), and 46.3% (19/41) in the pre-ERCP somatostatin, post-ERCP somatostatin, and placebo groups, respectively (P = 0.011). CONCLUSIONS: High-dose, long-term continuous infusion (0.5 mg/h for 24 hours) of somatostatin, performed as either a pre- or post-ERCP, can reduce the incidence of hyperamylasemia, but not PEP. SN - 2542-5641 UR - https://www.unboundmedicine.com/medline/citation/23823808/Is_prophylactic_somatostatin_effective_to_prevent_post_endoscopic_retrograde_cholangiopancreatography_pancreatitis_or_hyperamylasemia_A_randomized_placebo_controlled_pilot_trial_ L2 - https://Insights.ovid.com/pubmed?pmid=23823808 DB - PRIME DP - Unbound Medicine ER -