Intravenous bolus somatostatin after diagnostic cholangiopancreatography reduces the incidence of pancreatitis associated with therapeutic endoscopic retrograde cholangiopancreatography procedures: a randomised controlled trial
Background: Previous studies suggested that somatostatin given before endoscopic retrograde cholangiopancreatography (ERCP) may reduce the incidence of post-ERCP pancreatitis. However, the routine use of somatostatin in all patients undergoing ERCP is not likely to be cost effective. This study eval...
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| Veröffentlicht in: | Gut 2003-12, Vol.52 (12), p.1768-1773 |
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| creator | Poon, R T-P Yeung, C Liu, C-L Lam, C-M Yuen, W-K Lo, C-M Tang, A Fan, S-T |
| description | Background: Previous studies suggested that somatostatin given before endoscopic retrograde cholangiopancreatography (ERCP) may reduce the incidence of post-ERCP pancreatitis. However, the routine use of somatostatin in all patients undergoing ERCP is not likely to be cost effective. This study evaluated whether intravenous bolus somatostatin given after diagnostic cholangiopancreatography could reduce the incidence of pancreatitis in a group of patients undergoing therapeutic ERCP procedures. Methods: In a randomised, double blind, controlled trial, the effect of intravenous bolus somatostatin 250 μg given immediately after diagnostic cholangiopancreatography was compared with that of placebo in patients who required endoscopic sphincterotomy or other therapeutic procedures. The primary end point was the incidence of post-ERCP clinical pancreatitis, and a secondary end point was the incidence of hyperamylasemia. Results: A total of 270 patients were randomised. The somatostatin group (n = 135) and the placebo group (n = 135) were comparable in age, sex, indications for treatment, and types of procedure. The frequencies of clinical pancreatitis (4.4% v 13.3%; p = 0.010) and hyperamylasemia (26.0% v 38.5%; p = 0.036) were both significantly lower in the somatostatin group compared with the placebo group. Conclusions: A single dose of intravenous bolus somatostatin, given immediately after diagnostic cholangiopancreatography, is effective in reducing the incidence of pancreatitis after therapeutic ERCP. This novel approach of administering prophylactic somatostatin may offer a cost effective prophylaxis for post-ERCP pancreatitis. |
| doi_str_mv | 10.1136/gut.52.12.1768 |
| format | Article |
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However, the routine use of somatostatin in all patients undergoing ERCP is not likely to be cost effective. This study evaluated whether intravenous bolus somatostatin given after diagnostic cholangiopancreatography could reduce the incidence of pancreatitis in a group of patients undergoing therapeutic ERCP procedures. Methods: In a randomised, double blind, controlled trial, the effect of intravenous bolus somatostatin 250 μg given immediately after diagnostic cholangiopancreatography was compared with that of placebo in patients who required endoscopic sphincterotomy or other therapeutic procedures. The primary end point was the incidence of post-ERCP clinical pancreatitis, and a secondary end point was the incidence of hyperamylasemia. Results: A total of 270 patients were randomised. The somatostatin group (n = 135) and the placebo group (n = 135) were comparable in age, sex, indications for treatment, and types of procedure. The frequencies of clinical pancreatitis (4.4% v 13.3%; p = 0.010) and hyperamylasemia (26.0% v 38.5%; p = 0.036) were both significantly lower in the somatostatin group compared with the placebo group. Conclusions: A single dose of intravenous bolus somatostatin, given immediately after diagnostic cholangiopancreatography, is effective in reducing the incidence of pancreatitis after therapeutic ERCP. This novel approach of administering prophylactic somatostatin may offer a cost effective prophylaxis for post-ERCP pancreatitis.</description><identifier>ISSN: 0017-5749</identifier><identifier>EISSN: 1468-3288</identifier><identifier>EISSN: 1458-3288</identifier><identifier>DOI: 10.1136/gut.52.12.1768</identifier><identifier>PMID: 14633959</identifier><identifier>CODEN: GUTTAK</identifier><language>eng</language><publisher>London: BMJ Publishing Group Ltd and British Society of Gastroenterology</publisher><subject>Acute Disease ; Aged ; Amylases - blood ; Biological and medical sciences ; Care and treatment ; Causes of ; CBD ; Cholangiopancreatography, Endoscopic Retrograde - adverse effects ; Colorectal diseases ; common bile duct ; Complications and side effects ; Digestive system. Abdomen ; Dosage and administration ; Double-Blind Method ; Drug dosages ; Endoscopic retrograde cholangiopancreatography ; Endoscopy ; ERCP ; Female ; Gastrointestinal diseases ; Health aspects ; Heart attacks ; Hormones - administration & dosage ; Humans ; Hyperamylasemia - prevention & control ; Injections, Intravenous ; Investigative techniques, diagnostic techniques (general aspects) ; Male ; Medical sciences ; Middle Aged ; Mortality ; Pancreas ; Pancreatitis ; Pancreatitis - blood ; Pancreatitis - etiology ; Pancreatitis - prevention & control ; Patients ; Physiological aspects ; Prevention ; Risk factors ; Rodents ; Somatostatin ; Somatostatin - administration & dosage ; Studies ; Testing</subject><ispartof>Gut, 2003-12, Vol.52 (12), p.1768-1773</ispartof><rights>Copyright 2003 by Gut</rights><rights>2004 INIST-CNRS</rights><rights>COPYRIGHT 2003 BMJ Publishing Group Ltd.</rights><rights>Copyright: 2003 Copyright 2003 by Gut</rights><rights>Copyright © Copyright 2003 by Gut 2003</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b621t-4b62a2222aabce6a2b075a4e7c4e2e8c3161ea58c45a13d2321bad4a56b8d9f23</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1773906/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1773906/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=15319170$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/14633959$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Poon, R T-P</creatorcontrib><creatorcontrib>Yeung, C</creatorcontrib><creatorcontrib>Liu, C-L</creatorcontrib><creatorcontrib>Lam, C-M</creatorcontrib><creatorcontrib>Yuen, W-K</creatorcontrib><creatorcontrib>Lo, C-M</creatorcontrib><creatorcontrib>Tang, A</creatorcontrib><creatorcontrib>Fan, S-T</creatorcontrib><title>Intravenous bolus somatostatin after diagnostic cholangiopancreatography reduces the incidence of pancreatitis associated with therapeutic endoscopic retrograde cholangiopancreatography procedures: a randomised controlled trial</title><title>Gut</title><addtitle>Gut</addtitle><description>Background: Previous studies suggested that somatostatin given before endoscopic retrograde cholangiopancreatography (ERCP) may reduce the incidence of post-ERCP pancreatitis. However, the routine use of somatostatin in all patients undergoing ERCP is not likely to be cost effective. This study evaluated whether intravenous bolus somatostatin given after diagnostic cholangiopancreatography could reduce the incidence of pancreatitis in a group of patients undergoing therapeutic ERCP procedures. Methods: In a randomised, double blind, controlled trial, the effect of intravenous bolus somatostatin 250 μg given immediately after diagnostic cholangiopancreatography was compared with that of placebo in patients who required endoscopic sphincterotomy or other therapeutic procedures. The primary end point was the incidence of post-ERCP clinical pancreatitis, and a secondary end point was the incidence of hyperamylasemia. Results: A total of 270 patients were randomised. The somatostatin group (n = 135) and the placebo group (n = 135) were comparable in age, sex, indications for treatment, and types of procedure. The frequencies of clinical pancreatitis (4.4% v 13.3%; p = 0.010) and hyperamylasemia (26.0% v 38.5%; p = 0.036) were both significantly lower in the somatostatin group compared with the placebo group. Conclusions: A single dose of intravenous bolus somatostatin, given immediately after diagnostic cholangiopancreatography, is effective in reducing the incidence of pancreatitis after therapeutic ERCP. This novel approach of administering prophylactic somatostatin may offer a cost effective prophylaxis for post-ERCP pancreatitis.</description><subject>Acute Disease</subject><subject>Aged</subject><subject>Amylases - blood</subject><subject>Biological and medical sciences</subject><subject>Care and treatment</subject><subject>Causes of</subject><subject>CBD</subject><subject>Cholangiopancreatography, Endoscopic Retrograde - adverse effects</subject><subject>Colorectal diseases</subject><subject>common bile duct</subject><subject>Complications and side effects</subject><subject>Digestive system. Abdomen</subject><subject>Dosage and administration</subject><subject>Double-Blind Method</subject><subject>Drug dosages</subject><subject>Endoscopic retrograde cholangiopancreatography</subject><subject>Endoscopy</subject><subject>ERCP</subject><subject>Female</subject><subject>Gastrointestinal diseases</subject><subject>Health aspects</subject><subject>Heart attacks</subject><subject>Hormones - administration & dosage</subject><subject>Humans</subject><subject>Hyperamylasemia - prevention & control</subject><subject>Injections, Intravenous</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Pancreas</subject><subject>Pancreatitis</subject><subject>Pancreatitis - blood</subject><subject>Pancreatitis - etiology</subject><subject>Pancreatitis - prevention & control</subject><subject>Patients</subject><subject>Physiological aspects</subject><subject>Prevention</subject><subject>Risk factors</subject><subject>Rodents</subject><subject>Somatostatin</subject><subject>Somatostatin - administration & dosage</subject><subject>Studies</subject><subject>Testing</subject><issn>0017-5749</issn><issn>1468-3288</issn><issn>1458-3288</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqFkllv1DAQxyMEoqXwyiOyhEDiYZc4jnP0AamsOCrKIXG8WhNnkvWStRfbKfTz8kWY0KVLUQHHii37N__xHElyl6dzzkXxuB_jXGZzTrMsqmvJPs-Laiayqrqe7KcpL2eyzOu95FYIqzRNq6rmN5M9goSoZb2ffD-20cMpWjcG1riB_sGtIboQIRrLoIvoWWugt3RkNNNLN4DtjduA1R6J7D1slmfMYztqDCwukRmrTYtWI3Md-wWaaAKDEJw2ELFlX01cTjSZ4zhJo21d0G5DW4_RT8It_t3hxjtNPj2GQwbMA1mvTSBh7SgmNwy0jd7AcDu50cEQ8M52PUg-Pn_2YfFydvL2xfHi6GTWFBmPs5wWyGgANBoLyJq0lJBjqXPMsNKCFxxBVjqXwEWbiYw30OYgi6Zq6y4TB8mTc93N2Kyx1TildlAbb9bgz5QDoy7fWLNUvTtVvCxFnRYk8HAr4N2XEUNUFJDGgeJHqo8qec5TKQSB9_8AV270loKbtGqRpbXMdlQPAypjO0de9SSpjjjnhZTVT63ZFVSPlgozOIudoeNL_PwKnr4W10b_y0B7F4LH7iIjPFVTEytqYiUzxWlSE5PBvd_zuMO3XUvAgy0AQcPQUe21CTtOCl7zMt2FZkLEbxf34D-rohSlVG8-LVS-qN6_yp6-U6-Jf3TON-vV_x75A0l8H3w</recordid><startdate>20031201</startdate><enddate>20031201</enddate><creator>Poon, R T-P</creator><creator>Yeung, C</creator><creator>Liu, C-L</creator><creator>Lam, C-M</creator><creator>Yuen, W-K</creator><creator>Lo, C-M</creator><creator>Tang, A</creator><creator>Fan, S-T</creator><general>BMJ Publishing Group Ltd and British Society of Gastroenterology</general><general>BMJ</general><general>BMJ Publishing Group Ltd</general><general>BMJ Publishing Group LTD</general><general>Copyright 2003 by Gut</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>M7P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20031201</creationdate><title>Intravenous bolus somatostatin after diagnostic cholangiopancreatography reduces the incidence of pancreatitis associated with therapeutic endoscopic retrograde cholangiopancreatography procedures: a randomised controlled trial</title><author>Poon, R T-P ; Yeung, C ; Liu, C-L ; Lam, C-M ; Yuen, W-K ; Lo, C-M ; Tang, A ; Fan, S-T</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b621t-4b62a2222aabce6a2b075a4e7c4e2e8c3161ea58c45a13d2321bad4a56b8d9f23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Acute Disease</topic><topic>Aged</topic><topic>Amylases - blood</topic><topic>Biological and medical sciences</topic><topic>Care and treatment</topic><topic>Causes of</topic><topic>CBD</topic><topic>Cholangiopancreatography, Endoscopic Retrograde - adverse effects</topic><topic>Colorectal diseases</topic><topic>common bile duct</topic><topic>Complications and side effects</topic><topic>Digestive system. Abdomen</topic><topic>Dosage and administration</topic><topic>Double-Blind Method</topic><topic>Drug dosages</topic><topic>Endoscopic retrograde cholangiopancreatography</topic><topic>Endoscopy</topic><topic>ERCP</topic><topic>Female</topic><topic>Gastrointestinal diseases</topic><topic>Health aspects</topic><topic>Heart attacks</topic><topic>Hormones - administration & dosage</topic><topic>Humans</topic><topic>Hyperamylasemia - prevention & control</topic><topic>Injections, Intravenous</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Pancreas</topic><topic>Pancreatitis</topic><topic>Pancreatitis - blood</topic><topic>Pancreatitis - etiology</topic><topic>Pancreatitis - prevention & control</topic><topic>Patients</topic><topic>Physiological aspects</topic><topic>Prevention</topic><topic>Risk factors</topic><topic>Rodents</topic><topic>Somatostatin</topic><topic>Somatostatin - administration & dosage</topic><topic>Studies</topic><topic>Testing</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Poon, R T-P</creatorcontrib><creatorcontrib>Yeung, C</creatorcontrib><creatorcontrib>Liu, C-L</creatorcontrib><creatorcontrib>Lam, C-M</creatorcontrib><creatorcontrib>Yuen, W-K</creatorcontrib><creatorcontrib>Lo, C-M</creatorcontrib><creatorcontrib>Tang, A</creatorcontrib><creatorcontrib>Fan, S-T</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection (ProQuest)</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database (ProQuest)</collection><collection>Biological Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Gut</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Poon, R T-P</au><au>Yeung, C</au><au>Liu, C-L</au><au>Lam, C-M</au><au>Yuen, W-K</au><au>Lo, C-M</au><au>Tang, A</au><au>Fan, S-T</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Intravenous bolus somatostatin after diagnostic cholangiopancreatography reduces the incidence of pancreatitis associated with therapeutic endoscopic retrograde cholangiopancreatography procedures: a randomised controlled trial</atitle><jtitle>Gut</jtitle><addtitle>Gut</addtitle><date>2003-12-01</date><risdate>2003</risdate><volume>52</volume><issue>12</issue><spage>1768</spage><epage>1773</epage><pages>1768-1773</pages><issn>0017-5749</issn><eissn>1468-3288</eissn><eissn>1458-3288</eissn><coden>GUTTAK</coden><abstract>Background: Previous studies suggested that somatostatin given before endoscopic retrograde cholangiopancreatography (ERCP) may reduce the incidence of post-ERCP pancreatitis. However, the routine use of somatostatin in all patients undergoing ERCP is not likely to be cost effective. This study evaluated whether intravenous bolus somatostatin given after diagnostic cholangiopancreatography could reduce the incidence of pancreatitis in a group of patients undergoing therapeutic ERCP procedures. Methods: In a randomised, double blind, controlled trial, the effect of intravenous bolus somatostatin 250 μg given immediately after diagnostic cholangiopancreatography was compared with that of placebo in patients who required endoscopic sphincterotomy or other therapeutic procedures. The primary end point was the incidence of post-ERCP clinical pancreatitis, and a secondary end point was the incidence of hyperamylasemia. Results: A total of 270 patients were randomised. The somatostatin group (n = 135) and the placebo group (n = 135) were comparable in age, sex, indications for treatment, and types of procedure. The frequencies of clinical pancreatitis (4.4% v 13.3%; p = 0.010) and hyperamylasemia (26.0% v 38.5%; p = 0.036) were both significantly lower in the somatostatin group compared with the placebo group. Conclusions: A single dose of intravenous bolus somatostatin, given immediately after diagnostic cholangiopancreatography, is effective in reducing the incidence of pancreatitis after therapeutic ERCP. This novel approach of administering prophylactic somatostatin may offer a cost effective prophylaxis for post-ERCP pancreatitis.</abstract><cop>London</cop><pub>BMJ Publishing Group Ltd and British Society of Gastroenterology</pub><pmid>14633959</pmid><doi>10.1136/gut.52.12.1768</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Acute Disease Aged Amylases - blood Biological and medical sciences Care and treatment Causes of CBD Cholangiopancreatography, Endoscopic Retrograde - adverse effects Colorectal diseases common bile duct Complications and side effects Digestive system. Abdomen Dosage and administration Double-Blind Method Drug dosages Endoscopic retrograde cholangiopancreatography Endoscopy ERCP Female Gastrointestinal diseases Health aspects Heart attacks Hormones - administration & dosage Humans Hyperamylasemia - prevention & control Injections, Intravenous Investigative techniques, diagnostic techniques (general aspects) Male Medical sciences Middle Aged Mortality Pancreas Pancreatitis Pancreatitis - blood Pancreatitis - etiology Pancreatitis - prevention & control Patients Physiological aspects Prevention Risk factors Rodents Somatostatin Somatostatin - administration & dosage Studies Testing |
| title | Intravenous bolus somatostatin after diagnostic cholangiopancreatography reduces the incidence of pancreatitis associated with therapeutic endoscopic retrograde cholangiopancreatography procedures: a randomised controlled trial |
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