JOURNAL OF EVIDENCE BASED MEDICINE AND HEALTHCARE

Table of Contents

2018 Month : December Volume : 5 Issue : 49 Page : 3369-3373

THE ROLE OF PROPHYLACTIC OCTREOTIDE IN PREVENTING ERCP INDUCED PANCREATITIS..

Sadashiv N. Chaudhary1, Pranay R. Jaiswal2, Samir S. Deolekar3, Rajiv K. Karvande4, Anju Sharma5

Corresponding Author:
Dr. Pranay R. Jaiswal,
Room No. 218, RMO Hostel,
KEM Hospital.
Parel, Maharashtra.
E-mail: drpranayrjaiswal@gmail.com
DOI: 10.18410/jebmh/2018/686

ABSTRACT
BACKGROUND
Endoscopic Retrograde Cholangio-Pancreatography (ERCP) is a technique that uses a combination of luminal endoscopy and fluoroscopic imaging for diagnosis and treatment of pancreato-biliary system disorders. ERCP also has its own adverse effects which can be mild to severe and even life threatening.1,2 The common side effects of ERCP are: • Pancreatitis. • Haemorrhage. • Perforation. • Cholangitis. In this study, we are going to assess the role of prophylactic octreotide in preventing ERCP induced pancreatitis.
The objectives of the study were-
1. To find out the incidence of post-ERCP pancreatitis.
2. To evaluate the role of octreotide in preventing post-ERCP pancreatitis.

MATERIALS AND METHODS
In the period of study of 6 months, 240 patients who underwent ERCP were assessed for eligibility. Out of them, 127 patients were excluded from the study depending on the exclusion criteria. The rest 113 patients were randomized into two groups, the group A of 55 patients was assigned to patients who were given octreotide doses and a group of 58 patients was given 0.9% NS as placebo. The randomization was done using computer generated methods that randomized each subject to a single treatment by using the method of randomly permuted blocks.
Settings and Design- Inpatient male and female wards of the Department of General Surgery at a single center undergoing ERCP procedure in the Department of Medical Gastroenterology in a tertiary care center. We conducted a prospective, single center, open labelled, randomized placebo-controlled trial evaluating the role of prophylactic octreotide in the prevention of post-ERCP pancreatitis in patients undergoing the procedure and whether it has any implications on the severity of post-ERCP pancreatitis. The study was conducted over a period of six months.

RESULTS
There was a decrease in the incidence of Post ERCP pancreatitis in the group receiving octreotide (in the proposed dosage form and schedule) but the same was not statistically significant.

CONCLUSION
From an initial era of diagnosis and therapeutics to current times where the focus lies on safer techniques and refined procedure with good clinical outcome, ERCP has changed our understanding of the various hepatobiliary and pancreatic pathologies. Hence, focusing on adverse effects and finding methods to prevent the same has been a thrust area in this field. Pharmacologic prevention of pancreatitis which is one of its most common complications has brought forward various drugs including octreotide into trials.

KEYWORDS
Post ERCP Pancreatitis (PEP), Octreotide.