Background: Somatostatin is a potent inhibitor of pancreatic secretion and
has been studied for its prophylactic effect on post-ERCP pancreatitis. How
ever, results of previous trials have been inconclusive.
Methods: A prospective double-blind controlled study was performed to evalu
ate the effectiveness of somatostatin in preventing post-ERCP pancreatitis.
Post-ERCP enzyme elevation, abdominal pain and pancreatitis were evaluated
and compared between 109 patients randomized to receive somatostatin infus
ion and 111 patients randomized to receive normal saline infusion (placebo)
; both started 30 minutes before ERCP and continued for 12 hours.
Results: Post-ERCP elevation of serum amylase and lipase levers at 6 and 24
hours after ERCP was less frequent in the group given somatostatin but not
statistically significant. There was a tendency toward lower mean serum am
ylase and lipase levels at 24 hours in patients given somatostatin, althoug
h the difference was not statistically significant either. Eight patients g
iven somatostatin (7%) and 18 patients given placebo (16%) had significant
abdominal pain after ERCP requiring analgesia (p = 0.04). The frequency of
clinical pancreatitis was significantly lower in patients given somatostati
n (3%) than in those given placebo (10%) (p = 0.03).
Conclusions: Prophylactic treatment with somatostatin reduced the frequency
of post-ERCP pancreatitis.