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Intravenous synthetic secretin reduces the incidence of pancreatitis induced by endoscopic retrograde cholangiopancreatography.
MedLine Citation:
PMID:  21499206     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
OBJECTIVES: : This study aimed to evaluate whether synthetic secretin is effective in reducing post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis.
METHODS: : This is a single academic medical center, prospective, randomized, double-blind, placebo-controlled trial using secretin (dose of 16 μg) administered intravenously immediately before ERCP. Patients were evaluated for the primary outcome of post-ERCP pancreatitis as diagnosed by a single investigator.
RESULTS: : A total of 1100 patients were screened, of whom 869 were randomly assigned to receive secretin (n = 426) or placebo (n = 443) before ERCP and were evaluated after the procedure for efficacy of secretin. The incidence of pancreatitis in the secretin group compared with the placebo group was 36 (8.7%) of 413 patients versus 65 (15.1%) of 431 patients, respectively, P = 0.004. In the subgroup analysis, secretin was highly protective against post-ERCP pancreatitis for patients undergoing biliary sphincterotomy (6/129 vs 32/142, P < 0.001), patients undergoing cannulation of the common bile duct (26/339 vs 56/342, P < 0.001), and patients not undergoing pancreatic sphincterotomy (26/388 vs 57/403, P = 0.001). Analysis of the interaction between these groups reveals that the primary effect of secretin prophylaxis was prevention of post-ERCP pancreatitis in patients undergoing biliary sphincterotomy.
CONCLUSIONS: : Synthetic secretin reduces the risk of post-ERCP pancreatitis, particularly in patients in undergoing biliary sphincterotomy.
Authors:
Paul S Jowell; Malcolm S Branch; Seymour H Fein; Edward D Purich; Rakhi Kilaru; Gail Robuck; Philip d'Almada; John Baillie
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pancreas     Volume:  40     ISSN:  1536-4828     ISO Abbreviation:  Pancreas     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-04-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8608542     Medline TA:  Pancreas     Country:  United States    
Other Details:
Languages:  eng     Pagination:  533-9     Citation Subset:  IM    
Affiliation:
From the *Division of Gastroenterology, Duke University Medical Center, Durham, NC; †ChiRhoClin, Inc, Burtonsville, MD; ‡Duke Clinical Research Institute, Durham; §Ockham Development Group, Inc, Cary; and ∥Wake Forest University Baptist Medical Center, Winston-Salem, NC.
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