Somatostatin and gabexate for post‐endoscopic retrograde cholangiopancreatography pancreatitis prevention: Meta‐analysis of randomized placebo‐controlled trials

Abstract

Somatostatin administered as a bolus seems to be an efficacious measure of post-ERCP pancreatitis prevention, reducing pancreatitis and hyperamylasemia rates, and being applicable to clinical practice. Further study is required before its introduction into routine care.

Protease inhibitors for preventing complications associated with ERCP: an updated meta-analysis

“…2,3,22 The mortality rate was in the 0% to 3% range, comparable to mortality rates observed for post-ERCP pancreatitis in previous studies. 32 In the RCTs in this meta-analysis, limitations included discrepancies in definitions of post-ERCP pancreatitis and severity of pancreatitis. However, because pancreatitis appeared mild according to the characteristics of patients estimated from these results, the findings of this meta-analysis appear applicable to mild post-ERCP pancreatitis that occurs routinely.…”

“…Agreement between reviewers regarding selection of relevant articles was 100%. A total of 10 articles were excluded [26][27][28][29][30][31][32][33][34][35] : 10 articles met the exclusion criteria, 4 used protease inhibitors in both groups, [26][27][28][29] and 2 evaluated nonclinical outcomes, 30,31 2 review, 32,33 1 comment, 34 and 1 postoperative study. 35 We therefore analyzed 18 articles with a total of 4966 subjects (Online Table 1, available at www.giejournal.…”

Meta-analysis: somatostatin or its long-acting analogue, octreotide, for prophylaxis against post-ERCP pancreatitis

“…In 2007, Rudin et al [29] also performed a meta-analysis of five somatostatin studies, stratifying somatostatin administration into three groups: an infusion for 12 h or Fig. 8 Subgroup analysis of intention-to-treat studies by drugs.…”

“…Egger's test (P = 0.024) was significant for somatostatin, while it was not significant (P = 0.90) for octreotide more, an infusion for less than 12 h, and bolus infusion. They reported significant efficacy of somatostatin with an infusion for 12 h or more as well as for bolus infusion, with risk differences [95% CI] of 7.7% [3.4-12] and 8.2% [4.4-12], respectively [29]. They did not include three studies [3][4][5] that we included.…”

“…Two previous meta-analyses found no overall preventive efficacy of somatostatin [28,29]. Another metaanalysis suggested possible efficacy of high-dose (total dosage C0.5 mg) octreotide [30].…”