PREVENTION OF ACUTE PANCREATITIS DURING ENDOSCOPIC TRANSPAPILLARY INTERVENTIONS

Abstract

Aim. To identify the major risk factors of acute postoperative pancreatitis, to determine optimal volume of drug prevention, to study the possibility of intravenous administration of octreotide 600 mcg/ml in transpapillary endoscopic interventions. Material and Methods. In group I (72 patients) prevention of acute post-manipulation pancreatitis prior to endoscopic transpapillary interventions included intravenous administration of octreotide 600 mcg diluted in 60 ml 0.9% sodium chloride solution (NaCl). On the day of endoscopic intervention octreotide was administered fractionally 200 mcg 3 times per day. In group II (78 patients) acute pancreatitis was prevented by subcutaneous injection of octreotide 100 mcg before endoscopic intervention and subsequent 3-fold subcutaneous injection of 100 mcg on the day of surgery. Results. Risk factors of acute pancreatitis are young age, difficult cannulation of major duodenal papilla, atypical papillosphincterotomy, contrast injection into pancreatic duct. It is proved that intravenous administration of octreotide 600 mcg/ml reduces the risk of acute pancreatitis and transient hyperamylasemia from 16.7% and 19.2% to 11.1% and 16.7% respectively compared with conventional subcutaneous injection (100 mcg). Thus, it reduces the duration ( p < 0.016) and severity of hyperamylasemia (p < 0.005). Conclusion. Intravenous administration of octreotide 600 mcg/day is more effective and convenient compared with conventional scheme to prevent acute postmanipulation pancreatitis.