Effect of Calcitonin on the Serum Amylase Levels after Endoscopic Retrograde Cholangiopancreatography

Odes, H S; Novis, B.N.; Barbezat, G. O.; Bank, Simmy

doi:10.1159/000198070

Cited by 39 publications

(17 citation statements)

References 9 publications

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“…An ideal agent is highly effective in reducing pancreatitis, is safe for the patient, well tolerated, relatively affordable, and does not have a prolonged administration time [1] . Various pharmacological agents (such as nifedipine, glucagon, calcitonin, lidocaine, nitroglycerine, antibiotics, steroids, allopurinol, interleukin-10, and heparin) have been tried, but have met with disappointing results in preventing pancreatitis in randomized controlled trials [1,[22][23][24][25][26][27][28][29][30][31][32][33][34] . Only two agents seem to offer any clinical benefit: the protease inhibitor gabexate mesilate [35][36][37] and the antisecretory agent somatostatin may be efficacious in preventing pancreatitis when given by continuous IV infusion [34,38,39] .…”

Section: Discussionmentioning

confidence: 99%

Efficacy of intramuscular diclofenac and fluid replacement in prevention of post-ERCP pancreatitis

Senol¹,

Sarıtaş²,

Demirkan³

2009

WJG

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AIM:To assess the efficacy of intramuscular diclofenac and fluid replacement for prevention of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis. METHODS:A prospective, placebo-controlled study was conducted in 80 patients who underwent ERCP. Patients were randomized to receive parenteral diclofenac at a loading dose of 75 mg followed by the infusion of 5-10 mL/kg per hour isotonic saline over 4 h after the procedure, or the infusion of 500 mL isotonic saline as placebo. Patients were evaluated clinically, and serum amylase levels were measured 4, 8 and 24 h after the procedure. RESULTS:The two groups were matched for age, sex, underlying disease, ERCP findings, and type of treatment. The overall incidence of pancreatitis was 7.5% in the diclofenac group and 17.5% in the placebo group (12.5% in total). There were no significant differences in the incidence of pancreatitis and other variables between the two groups. In the subgroup analysis, the frequency of pancreatitis in the patients without sphincter of Oddi dysfunction (SOD) was significantly lower in the diclofenac group than in the control group (P = 0.047).CONCLUSION: Intramuscular diclofenac and fluid replacement lowered the rate of pancreatitis in patients without SOD.

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Section: Discussionmentioning

confidence: 99%

Efficacy of intramuscular diclofenac and fluid replacement in prevention of post-ERCP pancreatitis

Senol¹,

Sarıtaş²,

Demirkan³

2009

WJG

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“…Calcitonin has been studied and not been shown to have any prophylactic effect on pancreatic enzymes or complication rate [79,80] .…”

Section: Interruption Of Inflammatory Cascade (Anti-inflammatory): Nomentioning

confidence: 99%

Prevention of post-ERCP pancreatitis

Wong

Tsai

2014

WJGP

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Post-procedure pancreatitis is the most common complication of endoscopic retrograde cholangio pancreatography (ERCP) and carries a high morbidity and mortality occurring in at least 3%-5% of all procedures. We reviewed the available literature searching for "ERCP" and "pancreatitis" and "post-ERCP pancreatitis". in PubMed and Medline. This review looks at the diagnosis, risk factors, causes and methods of preventing post-procedure pancreatitis. These include the evidence for patient selection, endoscopic techniques and pharmacological prophylaxis of ERCP induced pancreatitis. Selecting the right patient for the procedure by a risk benefits assessment is the best way of avoiding unnecessary ERCPs. Risk is particularly high in young women with sphincter of Oddi dysfunction (SOD). Many of the trials reviewed have rather few numbers of subjects and hence difficult to appraise. Meta-analyses have helped screen for promising modalities of prophylaxis. At present, evidence is emerging that pancreatic stenting of patients with SOD and rectally administered nonsteroidal anti-inflammatory drugs in a large unselected trial reduce the risk of post-procedure pancreatitis. A recent meta-analysis have demonstrated that rectally administered indomethecin, just before or after ERCP is associated with significantly lower rate of pancreatitis compared with placebo [OR = 0.49 (0.34-0.71); P = 0.0002]. Number needed to treat was 20. It is likely that one of these prophylactic measures will begin to be increasingly practised in high risk groups.© 2014 Baishideng Publishing Group Co., Limited. All rights reserved. Key words: Acute pancreatitis; Endoscopic retrograde cholangio pancreatographyCore tip: Select patients carefully, and give high risk patients rectal indomethacin.Wong LL, Tsai HH. Prevention of post-ERCP pancreatitis.

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“…The results of several placebo‐controlled trials using prophylactic agents such as glucagon, 15 calcitonin, 16,17 nifedipin, 18,19 octreotide 20 and corticosteroids 21 have been disappointing. Meta‐analysis suggests that somatostatin, an antisecretory agent, and gabexate, a protease inhibitor, are effective in preventing post‐ERCP pancreatits; 1 however, both agents must be given before ERCP and continued for a 12‐h infusion afterward 22 .…”

Section: Introductionmentioning

confidence: 99%

Role of diclofenac in reducing post‐endoscopic retrograde cholangiopancreatography pancreatitis

Khoshbaten¹,

Khorram

Madad

et al. 2008

J of Gastro and Hepatol

126

105

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Wang ZH, Mo JZ, Xiao SD. Effects of thalidomide in experimental models of post-endoscopic retrograde cholangiopancreatography pancreatitis. J. Gastroenterol. Hepatol. 2007; 22: 371-6. 18 He ZJ, Winston JH, Yusuf Te et al. Intraductal administration of an NK1 receptor antagonist attenuates the inflammatory response to retrograde infusion of radiological contrast in rats: implications for the pathogenesis and prevention of ERCP-induced pancreatitis. Pancreas 2003; 27: e13-7. 19 Khoshbaten M, Khorram H, Madad L, Ardakani MJE, Farzin H, Zali MR. Role of diclofenac in reducing post-endoscopic retrograde cholangiopancreatography pancreatitis. Andriulli A, Leandro G, Federici T et al. Prophylactic administration of somatostatin or gabexate does not prevent pancreatitis after ERCP: an updated meta-analysis. Gastrointest. Endosc. 2007; 65: 624-32. 22 Rudin D, Kiss A, Wetz RV, Sottile VM. Somatostatin and gabexate for post-endoscopic retrograde cholangiopancreatography pancreatitis prevention: meta-analysis of randomized placebo controlled trials. J. Gastroenterol. Hepatol. 2007; 22: 977-83. 23 Thomopoulos KC, Pagoni NA, Vagenas KA, Margaritis VG, Theocharis GI, Nikolopoulou VN. Twenty-four hour prophylaxis with increased dosage of octreotide reduces the incidence of post-ERCP pancreatitis. Gastrointest. Endosc. 2006; 64: 726-31. 24 Singh P, Das A, Isenberg G et al. Do prophylactic stent placement reduces risk of post-ERCP acute pancreatitis: a meta-analysis of controlled trials. Gastrointest. Endosc. 2004; 60: 544-50. 25 Andriulli A, Forlano R, Napolitano G et al. Pancreatic duct stents in the prophylaxis of pancreatic damage after endoscopic retrograde cholangiopancreatography: a systematic analysis of benefits and associated risks. Digestion 2007; 75: 156-63. 26 Das A, Singh P, Sivak MV Jr et al. Pancreatic stent placement for prevention of post-ERCP pancreatitis: a cost effectiveness analysis. Gastrointest. Endosc. 2007; 65: 960-8. 27 Freeman ML, Overby C, Qi D. Pancreatic stent insertion: consequences of failure and results of a modified technique to maximize success. Gastrointest. Endosc. 2004; 59: 8-14. 28 Sherman S, Hawes RH, Savides TJ et al. Stent-induced pancreatic ductal and parenchymal changes: correlation of endoscopic ultrasound with ERCP. Gastrointest. Endosc. 1996; 44: 276-82. 29 Rashdan A, Fogel EL, McHenry L Jr, Sherman S, Temkit M, Lehman GA. Improved stent characteristics for prophylaxis of post-ERCP pancreatitis. Clin. Gastroenterol. Hepatol. 2004; 2: 322-9. 30 Lawrence C, Cotton PB, Romagnuolo J, Payne KM, Rawls E, Hawes RH. Small prophylactic pancreatic duct stents: an assessment

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Effect of Calcitonin on the Serum Amylase Levels after Endoscopic Retrograde Cholangiopancreatography

Abstract: Calcitonin or placebo was infused in a double-blind study in 30 patients undergoing endoscopic retrograde cholangiopancreatography. Calcitonin was found to have no significant effect on the hyperamylasemia following this procedure.

Cited by 39 publications

References 9 publications

Efficacy of intramuscular diclofenac and fluid replacement in prevention of post-ERCP pancreatitis

Efficacy of intramuscular diclofenac and fluid replacement in prevention of post-ERCP pancreatitis

Prevention of post-ERCP pancreatitis

Role of diclofenac in reducing post‐endoscopic retrograde cholangiopancreatography pancreatitis

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