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Prophylactic effect of somatostatin in preventing Post-ERCP pancreatitis: an updated meta-analysis.
Saudi J Gastroenterol. 2015 Nov-Dec; 21(6):372-8.SJ

Abstract

BACKGROUND/AIMS

Somatostatin is regarded as a prophylactic agent on post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP), but studies are still controversial.

MATERIALS AND METHODS

Electronic databases, including PubMed, EMBASE, the Cochrane library, and the Science Citation Index, were searched to retrieve relevant trials. In addition, meeting abstracts and the reference lists of retrieved articles were reviewed for further relevant studies.

RESULTS

Eleven randomized controlled trials (RCTs), enrolling a total of 2869 patients, were included in the meta-analysis. After data were pooled from somatostatin trials, PEP occurred in 8.36% of controls versus 5.62% of the treated group, with a slight significance [relative risk (RR) =0.58, 95% confidence interval (CI) 0.35-0.98, P = 0.04]. The funnel plot showed no asymmetry with a negative slope (P = 0.108). The meta-analysis produced negative results for short-term infusion of somatostatin (RR = 1.40, 95% CI 0.93-2.12, P = 0.11), whereas a bolus or long-term injection of the drug proved effective (RR = 0.25, 95% CI 0.13-0.47,P < 0.0001; RR = 0.44, 95% CI 0.27-0.71,P = 0.0008). Postprocedure hyperamylasemia and pain was also observed in the meta-analysis, the pooled RR was significant for reduced risk of postprocedure hyperamylasemia (RR = 0.72, 95%CI 0.63 to 0.81,P < 0.00001), but not for the pain (RR = 0.67, 95% CI 0.42 to 1.08,P= 0.10).

CONCLUSION

The current meta-analysis on the prophylactic use of somatostatin in patients undergoing ERCP documents a lack of benefit when given as short-term infusion, but showed an advantage of a single bolus or long-term injection. The beneficial effect of somatostatin, in reducing the incidence of postprocedural hyperamylasemia seems of marginal clinical significance. However, more new confirmatory data are needed to settle residual doubts.

Authors+Show Affiliations

No affiliation info availableNo affiliation info availableNo affiliation info availableDepartment of Human Anatomy, College of Basic and Forensic Medicine, Sichuan University, Chengdu, Sichuan Province, China.

Pub Type(s)

Journal Article
Meta-Analysis

Language

eng

PubMed ID

26655132

Citation

Qin, Xie, et al. "Prophylactic Effect of Somatostatin in Preventing Post-ERCP Pancreatitis: an Updated Meta-analysis." Saudi Journal of Gastroenterology : Official Journal of the Saudi Gastroenterology Association, vol. 21, no. 6, 2015, pp. 372-8.
Qin X, Lei WS, Xing ZX, et al. Prophylactic effect of somatostatin in preventing Post-ERCP pancreatitis: an updated meta-analysis. Saudi J Gastroenterol. 2015;21(6):372-8.
Qin, X., Lei, W. S., Xing, Z. X., & Shi, F. (2015). Prophylactic effect of somatostatin in preventing Post-ERCP pancreatitis: an updated meta-analysis. Saudi Journal of Gastroenterology : Official Journal of the Saudi Gastroenterology Association, 21(6), 372-8. https://doi.org/10.4103/1319-3767.167187
Qin X, et al. Prophylactic Effect of Somatostatin in Preventing Post-ERCP Pancreatitis: an Updated Meta-analysis. Saudi J Gastroenterol. 2015 Nov-Dec;21(6):372-8. PubMed PMID: 26655132.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prophylactic effect of somatostatin in preventing Post-ERCP pancreatitis: an updated meta-analysis. AU - Qin,Xie, AU - Lei,Wen S, AU - Xing,Zhang X, AU - Shi,Feng, PY - 2015/12/15/entrez PY - 2015/12/15/pubmed PY - 2016/10/27/medline SP - 372 EP - 8 JF - Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association JO - Saudi J Gastroenterol VL - 21 IS - 6 N2 - BACKGROUND/AIMS: Somatostatin is regarded as a prophylactic agent on post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP), but studies are still controversial. MATERIALS AND METHODS: Electronic databases, including PubMed, EMBASE, the Cochrane library, and the Science Citation Index, were searched to retrieve relevant trials. In addition, meeting abstracts and the reference lists of retrieved articles were reviewed for further relevant studies. RESULTS: Eleven randomized controlled trials (RCTs), enrolling a total of 2869 patients, were included in the meta-analysis. After data were pooled from somatostatin trials, PEP occurred in 8.36% of controls versus 5.62% of the treated group, with a slight significance [relative risk (RR) =0.58, 95% confidence interval (CI) 0.35-0.98, P = 0.04]. The funnel plot showed no asymmetry with a negative slope (P = 0.108). The meta-analysis produced negative results for short-term infusion of somatostatin (RR = 1.40, 95% CI 0.93-2.12, P = 0.11), whereas a bolus or long-term injection of the drug proved effective (RR = 0.25, 95% CI 0.13-0.47,P < 0.0001; RR = 0.44, 95% CI 0.27-0.71,P = 0.0008). Postprocedure hyperamylasemia and pain was also observed in the meta-analysis, the pooled RR was significant for reduced risk of postprocedure hyperamylasemia (RR = 0.72, 95%CI 0.63 to 0.81,P < 0.00001), but not for the pain (RR = 0.67, 95% CI 0.42 to 1.08,P= 0.10). CONCLUSION: The current meta-analysis on the prophylactic use of somatostatin in patients undergoing ERCP documents a lack of benefit when given as short-term infusion, but showed an advantage of a single bolus or long-term injection. The beneficial effect of somatostatin, in reducing the incidence of postprocedural hyperamylasemia seems of marginal clinical significance. However, more new confirmatory data are needed to settle residual doubts. SN - 1998-4049 UR - https://www.unboundmedicine.com/medline/citation/26655132/Prophylactic_effect_of_somatostatin_in_preventing_Post_ERCP_pancreatitis:_an_updated_meta_analysis_ L2 - http://www.saudijgastro.com/article.asp?issn=1319-3767;year=2015;volume=21;issue=6;spage=372;epage=378;aulast=Qin DB - PRIME DP - Unbound Medicine ER -