Effect of octreotide on the prevention of hyperamylasemia after ERCP in Saudi Arabia: a prospective study

Acute pancreatitis is a serious complication of ERCP. Octreotide as prophylaxis against ERCP-induced hyperamylasemia has produced conflicting results. A review article has called for additional controlled studies. This work was undertaken to see the effect of octreotide in ERCP-induced enzyme changes in a predominantly Saudi population.

The setting was a university teaching hospital, Eastern Saudi Arabia. The study was prospective, randomized and controlled and the subjects were 50 consecutive adult in-patients. Octreotide, 200 tg subcutaneous, was used in the study group (27 patients). Levels of serum amylase and lipase were estimated three times post-ERCP; mean values were compared with the control group (23 patients) using student t test.

A total of 50 patients were studied. Their mean age was 43 (range 19 to 70); 30 were female, a male:female ratio of 1:1.5. The two groups were comparable in terms of age, sex and nationality as well as clinical, haematological and biochemical variables. In both groups, the serum levels of amylase and lipase 4 hours post-ERCP were significantly higher compared with base line levels. However, there were no statistical differences between the mean post-ERCP values within as well as between the two groups of patient studied. However, the pattern of response appeared to be different when amylase was compared with lipase.

Prophylactic octreotide, in the regimen used in this study, does not protect against post-ERCP hyperamylasemia and hyperlipasemia. The observed apparent difference in the pattern of serum amylase and lipase remains to be confirmed.