Therapeutic value of somatostatin and nitroglycerin for prevention of post-ERCP pancreatitis

Abstract

Objective To investigate the preventive effect of somatostatin and nitroglycerin on post- ERCP pancreatitis （PEP） and hyperamylasemia. Methods A total of 184 patients who underwent endo- scopic retrograde cholangiopancreatograph （ERCP） were enrolled, and randomly divided into three groups to receive somatostatin or nitroglycerin or normal saline according to random number table. Incidence of PEP and hyperamylasemia were observed and compared among the three groups. Results Nine patients stopped the medication and dropped out of the study after occurence of adverse reactions from receiving nitroglycerin injections. The incidence rates of hyperamylasemia were 38. 7% （24/62）, 51.8% （28/54） and 37.3% （22/59） in somatostatin, nitroglycerin and control group respectively, with no significant differences among the three groups （P 〉0. 05）. The incidence rates of PEP were 6, 4% （4/62）, 9. 3% （5/54） and 23.7% （14/59） in somatostatin, nitroglycerin and control group, respectively. The incidence rates of PEP in soma- tostatin and nitroglycerin group were both significantly lower than that in control group （ somatostatin group vs control group..）（2 =7. 13 ,P =0. 01 ; nitroglycerin group vs control group..）（~ =4. 22,P =0. 03）. There was no significant difference between somatostatin group and nitroglycerin group （X2 --0, 32, P = 0.41 ）. Conclusion Somatostatin and nitroglycerin injections after ERCP show similar efficacy on preventing PEP, but the for- mer is safer. Both have little effects on the prophylaxis of hyperamylaemia. Key words: Cholangiopancreatography, endoscopic retrograde ; Pancreatitis; Hyperamylasemia; Somatostatin ; Nitroglycerin