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Article: Antisecretory agents for prevention of post-ERCP pancreatitis: Rationale for use and clinical results

TitleAntisecretory agents for prevention of post-ERCP pancreatitis: Rationale for use and clinical results
Authors
KeywordsCholangiopancreatography, endoscopic retrograde
Endoscopic sphincterotomy
Octreotide
Somatostatin
Issue Date2003
PublisherE S Burioni Ricerche Bibliografiche. The Journal's web site is located at http://www.joplink.net
Citation
Journal Of The Pancreas, 2003, v. 4 n. 1, p. 33-40 How to Cite?
AbstractAcute pancreatitis is the most common complication of endoscopic retrograde cholangiopancreatography (ERCP). Over the past decade, there has been notable research on the use of various prophylactic agents in preventing post-ERCP pancreatitis. The most widely investigated drug is the antisecretory agent somatostatin and its analogue octreotide. Both agents are potent inhibitors of exocrine secretion of the pancreas, which plays an important role in the pathogenesis of acute pancreatitis by causing autodigestion of pancreas. In addition, somatostatin and octreotide appear to have anti-inflammatory and cytoprotective effects, both of which may be protective against post-ERCP pancreatitis. Furthermore, somatostatin has been shown to relax the sphincter of Oddi, whereas octreotide increases the basal pressure of the sphincter. Several randomized controlled trials have evaluated the efficacy of somatostatin and octreotide in reducing post-ERCP pancreatitis. The results of these trials vary due to different patient populations and experimental designs. Overall, the available evidence suggests that somatostatin reduces the incidence of post-ERCP pancreatitis, whereas octreotide does not. Whether the difference in efficacy between the two drugs is related to their differential effects on sphincter of Oddi motility or is due to other reasons remains unclear. Although there is some evidence supporting the use of somatostatin in reducing the frequency of post-ERCP pancreatitis, it is widely agreed that generalized treatment of all patients undergoing ERCP with prophylactic somatostatin may not be cost-effective. Further studies should focus on the elucidation of the most cost-effective dosage regimen of somatostatin and it efficacy in patients at high risk for post-ERCP pancreatitis.
Persistent Identifierhttp://hdl.handle.net/10722/83651
ISSN
2015 SCImago Journal Rankings: 0.337
References

 

DC FieldValueLanguage
dc.contributor.authorPoon, RTPen_HK
dc.contributor.authorFan, STen_HK
dc.date.accessioned2010-09-06T08:43:34Z-
dc.date.available2010-09-06T08:43:34Z-
dc.date.issued2003en_HK
dc.identifier.citationJournal Of The Pancreas, 2003, v. 4 n. 1, p. 33-40en_HK
dc.identifier.issn1590-8577en_HK
dc.identifier.urihttp://hdl.handle.net/10722/83651-
dc.description.abstractAcute pancreatitis is the most common complication of endoscopic retrograde cholangiopancreatography (ERCP). Over the past decade, there has been notable research on the use of various prophylactic agents in preventing post-ERCP pancreatitis. The most widely investigated drug is the antisecretory agent somatostatin and its analogue octreotide. Both agents are potent inhibitors of exocrine secretion of the pancreas, which plays an important role in the pathogenesis of acute pancreatitis by causing autodigestion of pancreas. In addition, somatostatin and octreotide appear to have anti-inflammatory and cytoprotective effects, both of which may be protective against post-ERCP pancreatitis. Furthermore, somatostatin has been shown to relax the sphincter of Oddi, whereas octreotide increases the basal pressure of the sphincter. Several randomized controlled trials have evaluated the efficacy of somatostatin and octreotide in reducing post-ERCP pancreatitis. The results of these trials vary due to different patient populations and experimental designs. Overall, the available evidence suggests that somatostatin reduces the incidence of post-ERCP pancreatitis, whereas octreotide does not. Whether the difference in efficacy between the two drugs is related to their differential effects on sphincter of Oddi motility or is due to other reasons remains unclear. Although there is some evidence supporting the use of somatostatin in reducing the frequency of post-ERCP pancreatitis, it is widely agreed that generalized treatment of all patients undergoing ERCP with prophylactic somatostatin may not be cost-effective. Further studies should focus on the elucidation of the most cost-effective dosage regimen of somatostatin and it efficacy in patients at high risk for post-ERCP pancreatitis.en_HK
dc.languageengen_HK
dc.publisherE S Burioni Ricerche Bibliografiche. The Journal's web site is located at http://www.joplink.neten_HK
dc.relation.ispartofJournal of the Pancreasen_HK
dc.subjectCholangiopancreatography, endoscopic retrogradeen_HK
dc.subjectEndoscopic sphincterotomyen_HK
dc.subjectOctreotideen_HK
dc.subjectSomatostatinen_HK
dc.titleAntisecretory agents for prevention of post-ERCP pancreatitis: Rationale for use and clinical resultsen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1680-2292&volume=4&spage=33&epage=40&date=2003&atitle=Antisecretory+agents+for+prevention+of+post-ERCP+pancreatitis:+rationale+for+use+and+clinical+resultsen_HK
dc.identifier.emailPoon, RTP: poontp@hkucc.hku.hken_HK
dc.identifier.emailFan, ST: stfan@hku.hken_HK
dc.identifier.authorityPoon, RTP=rp00446en_HK
dc.identifier.authorityFan, ST=rp00355en_HK
dc.description.naturelink_to_OA_fulltext-
dc.identifier.pmid12555014-
dc.identifier.scopuseid_2-s2.0-0037267964en_HK
dc.identifier.hkuros79144en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0037267964&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume4en_HK
dc.identifier.issue1en_HK
dc.identifier.spage33en_HK
dc.identifier.epage40en_HK
dc.publisher.placeItalyen_HK
dc.identifier.scopusauthoridPoon, RTP=7103097223en_HK
dc.identifier.scopusauthoridFan, ST=7402678224en_HK

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