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Efforts to prevent pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP) have focused on placement of pancreatic stents, avoidance of high-risk and low-yield procedures, and use of prophylactic pharmacologic agents. Researchers from Greece sought to determine whether octreotide (Sandostatin), a potent inhibitor of pancreatic secretion, could lower the incidence of post-ERCP pancreatitis in a double-blind, placebo-controlled trial that involved 202 consecutive inpatients (mean age, 70). Patients were excluded if they had prior sphincterotomy, chronic pancreatitis, or ongoing acute pancreatitis.
Patients were randomized to subcutaneous octreotide (500 μg) or placebo at 24, 16, 8, and 1 hour before ERCP and at 8 hours after E…