Aryan Modasi, MD, BHSc. Memorial University
Background: Following diagnostic/therapeutic ERCP, pancreatitis can occur in up to 9.7% of cases. For the last two decades research has been done looking at potentially effective pharmacologic prophylaxis, with several meta-analysis looking at somatostatin administration peri-procedurally. While no conclusive answer has been found, sub-group analysis has pointed towards a potential benefit with bolus somatostatin administration. This meta-analysis is the first dedicated review looking at only bolus somatostatin administration for reduction of post-ERCP pancreatitis.
Methods: A systematic review and meta-analysis was performed on all studies involving patients undergoing ERCP, who received bolus somatostatin compared to no pharmacological prophylaxis. A literature search was conducted on MEDLINE, EMBASE, and CINAHL. Articles were appraised by two current senior general surgical residents in the Memorial University program.
Results: Four studies were included in the final systematic review/meta-analysis. Following tabulation of all four studies somatostatin bolus was found significantly reduce the incidence of post-ERCP pancreatitis (OR 0.27 [0.13-0.53]).
Conclusion: Bolus somatostatin injection during ERCP decreases the incidence of post-procedure pancreatitis. While this review has found this effect to be statistically significant, limitations in interpretation of these results arises due to the inherent methodological flaws within two of the included studies. Never-the-less an argument can be made that bolus somatostatin injection is a safe and effective measure to decrease the incidence of post-ERCP pancreatitis, and that further exploration into its use is warranted.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 77569
Program Number: P344
Presentation Session: Poster (Non CME)
Presentation Type: Poster