Effect of Somatostatin Plus Diclofenac in Comparison with Diclofenac Before ERCP on the Pancreatitis Double Blinded Randomized Clinical Trial

Homa Abri; Farhad Zamani; Mahsa Agahi; Hossein Ajdarkosh; Amirhossein Faraji; Mahmoodreza Khoonsari; Elham Sobhrakhshankhah; Nima Motamed; Masoudreza Sohrabi; Fahimeh Safarnezhad Tameshkel; Roghaye Sahraei; Pardis Sadeghipour; Mehdi Nikkhah

doi:doi:10.11648/j.ijg.20230701.12

Effect of Somatostatin Plus Diclofenac in Comparison with Diclofenac Before ERCP on the Pancreatitis Double Blinded Randomized Clinical Trial

Homa Abri, Farhad Zamani, Mahsa Agahi, Hossein Ajdarkosh, Amirhossein Faraji, Mahmoodreza Khoonsari, Elham Sobhrakhshankhah, Nima Motamed, Masoudreza Sohrabi, Fahimeh Safarnezhad Tameshkel, Roghaye Sahraei, Pardis Sadeghipour, Mehdi Nikkhah

Published in International Journal of Gastroenterology (Volume 7, Issue 1)

Received: 8 December 2022 Accepted: 16 February 2023 Published: 20 March 2023

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Abstract

Background/Aims: Despite many therapeutic attempts, post-retrograde cholangiopancreatography pancreatitis (PEP) has remained as a major challenge in interventional endoscopy. This study aimed to compare the effects of intravenous somatostatin plus rectal diclofenac with rectal diclofenac alone in the prevention of PEP. Methods: In a double-blind, randomized clinical trial, patients candidate for ERCP who accepted the study protocol were enrolled in the study between 2019 and 2021. The exclusion criteria include a history of pancreatobiliary surgery, ERCP, acute pancreatitis, contraindication, sensitivity to somatostatin, diclofenac, and pregnancy. PEP was defined as abdominal pain with elevated amylase level. Patients who received intravenous somatostatin plus diclofenac and diclofenac alone enrolled in case group and control group respectively. Patients were followed up for 24h after the procedure. Data regarding demographic, clinical presentation and laboratories results were recorded and compared. Results: A total 186 patients were enrolled, 91 in the case group and 95 as controls. There was no statistically significant difference between the two groups in terms of PEP incidence, complications or changes in serum amylase level (p > 0.05). Conclusion: Rectal diclofenac combined with intravenous somatostatin was superior to rectal diclofenac alone to prevent PE, but without a statistically significant difference, which is probably due to the synergic effect of somatostatin and diclofenac.

Published in	International Journal of Gastroenterology (Volume 7, Issue 1)
DOI	10.11648/j.ijg.20230701.12
Page(s)	15-20
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2023. Published by Science Publishing Group

Keywords

Diclofenac, ERCP, Post-ERCP Pancreatitis, Somatostatin

References

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[19]	Cheon YK, Cho KB, Watkins JL, McHenry L, Fogel EL, Sherman S, et al. Efficacy of diclofenac in the prevention of post-ERCP pancreatitis in predominantly high-risk patients: a randomized double-blind prospective trial. Gastrointest Endosc 2007; 66: 1126–32.
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APA Style

Homa Abri, Farhad Zamani, Mahsa Agahi, Hossein Ajdarkosh, Amirhossein Faraji, et al. (2023). Effect of Somatostatin Plus Diclofenac in Comparison with Diclofenac Before ERCP on the Pancreatitis Double Blinded Randomized Clinical Trial. International Journal of Gastroenterology, 7(1), 15-20. https://doi.org/10.11648/j.ijg.20230701.12

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ACS Style

Homa Abri; Farhad Zamani; Mahsa Agahi; Hossein Ajdarkosh; Amirhossein Faraji, et al. Effect of Somatostatin Plus Diclofenac in Comparison with Diclofenac Before ERCP on the Pancreatitis Double Blinded Randomized Clinical Trial. Int. J. Gastroenterol. 2023, 7(1), 15-20. doi: 10.11648/j.ijg.20230701.12

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AMA Style

Homa Abri, Farhad Zamani, Mahsa Agahi, Hossein Ajdarkosh, Amirhossein Faraji, et al. Effect of Somatostatin Plus Diclofenac in Comparison with Diclofenac Before ERCP on the Pancreatitis Double Blinded Randomized Clinical Trial. Int J Gastroenterol. 2023;7(1):15-20. doi: 10.11648/j.ijg.20230701.12

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@article{10.11648/j.ijg.20230701.12,
  author = {Homa Abri and Farhad Zamani and Mahsa Agahi and Hossein Ajdarkosh and Amirhossein Faraji and Mahmoodreza Khoonsari and Elham Sobhrakhshankhah and Nima Motamed and Masoudreza Sohrabi and Fahimeh Safarnezhad Tameshkel and Roghaye Sahraei and Pardis Sadeghipour and Mehdi Nikkhah},
  title = {Effect of Somatostatin Plus Diclofenac in Comparison with Diclofenac Before ERCP on the Pancreatitis Double Blinded Randomized Clinical Trial},
  journal = {International Journal of Gastroenterology},
  volume = {7},
  number = {1},
  pages = {15-20},
  doi = {10.11648/j.ijg.20230701.12},
  url = {https://doi.org/10.11648/j.ijg.20230701.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijg.20230701.12},
  abstract = {Background/Aims: Despite many therapeutic attempts, post-retrograde cholangiopancreatography pancreatitis (PEP) has remained as a major challenge in interventional endoscopy. This study aimed to compare the effects of intravenous somatostatin plus rectal diclofenac with rectal diclofenac alone in the prevention of PEP. Methods: In a double-blind, randomized clinical trial, patients candidate for ERCP who accepted the study protocol were enrolled in the study between 2019 and 2021. The exclusion criteria include a history of pancreatobiliary surgery, ERCP, acute pancreatitis, contraindication, sensitivity to somatostatin, diclofenac, and pregnancy. PEP was defined as abdominal pain with elevated amylase level. Patients who received intravenous somatostatin plus diclofenac and diclofenac alone enrolled in case group and control group respectively. Patients were followed up for 24h after the procedure. Data regarding demographic, clinical presentation and laboratories results were recorded and compared. Results: A total 186 patients were enrolled, 91 in the case group and 95 as controls. There was no statistically significant difference between the two groups in terms of PEP incidence, complications or changes in serum amylase level (p > 0.05). Conclusion: Rectal diclofenac combined with intravenous somatostatin was superior to rectal diclofenac alone to prevent PE, but without a statistically significant difference, which is probably due to the synergic effect of somatostatin and diclofenac.},
 year = {2023}
}

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TY  - JOUR
T1  - Effect of Somatostatin Plus Diclofenac in Comparison with Diclofenac Before ERCP on the Pancreatitis Double Blinded Randomized Clinical Trial
AU  - Homa Abri
AU  - Farhad Zamani
AU  - Mahsa Agahi
AU  - Hossein Ajdarkosh
AU  - Amirhossein Faraji
AU  - Mahmoodreza Khoonsari
AU  - Elham Sobhrakhshankhah
AU  - Nima Motamed
AU  - Masoudreza Sohrabi
AU  - Fahimeh Safarnezhad Tameshkel
AU  - Roghaye Sahraei
AU  - Pardis Sadeghipour
AU  - Mehdi Nikkhah
Y1  - 2023/03/20
PY  - 2023
N1  - https://doi.org/10.11648/j.ijg.20230701.12
DO  - 10.11648/j.ijg.20230701.12
T2  - International Journal of Gastroenterology
JF  - International Journal of Gastroenterology
JO  - International Journal of Gastroenterology
SP  - 15
EP  - 20
PB  - Science Publishing Group
SN  - 2640-169X
UR  - https://doi.org/10.11648/j.ijg.20230701.12
AB  - Background/Aims: Despite many therapeutic attempts, post-retrograde cholangiopancreatography pancreatitis (PEP) has remained as a major challenge in interventional endoscopy. This study aimed to compare the effects of intravenous somatostatin plus rectal diclofenac with rectal diclofenac alone in the prevention of PEP. Methods: In a double-blind, randomized clinical trial, patients candidate for ERCP who accepted the study protocol were enrolled in the study between 2019 and 2021. The exclusion criteria include a history of pancreatobiliary surgery, ERCP, acute pancreatitis, contraindication, sensitivity to somatostatin, diclofenac, and pregnancy. PEP was defined as abdominal pain with elevated amylase level. Patients who received intravenous somatostatin plus diclofenac and diclofenac alone enrolled in case group and control group respectively. Patients were followed up for 24h after the procedure. Data regarding demographic, clinical presentation and laboratories results were recorded and compared. Results: A total 186 patients were enrolled, 91 in the case group and 95 as controls. There was no statistically significant difference between the two groups in terms of PEP incidence, complications or changes in serum amylase level (p > 0.05). Conclusion: Rectal diclofenac combined with intravenous somatostatin was superior to rectal diclofenac alone to prevent PE, but without a statistically significant difference, which is probably due to the synergic effect of somatostatin and diclofenac.
VL  - 7
IS  - 1
ER  -

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Author Information

Homa Abri

Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
Farhad Zamani

Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
Mahsa Agahi

Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
Hossein Ajdarkosh

Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
Amirhossein Faraji

Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
Mahmoodreza Khoonsari

Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
Elham Sobhrakhshankhah

Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
Nima Motamed

Department of Social Medicine, Zanjan University of Medical Science, Zanjan, Iran
Masoudreza Sohrabi

Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
Fahimeh Safarnezhad Tameshkel

Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
Roghaye Sahraei

Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
Pardis Sadeghipour

Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
Mehdi Nikkhah

Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran

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APA Style

Homa Abri, Farhad Zamani, Mahsa Agahi, Hossein Ajdarkosh, Amirhossein Faraji, et al. (2023). Effect of Somatostatin Plus Diclofenac in Comparison with Diclofenac Before ERCP on the Pancreatitis Double Blinded Randomized Clinical Trial. International Journal of Gastroenterology, 7(1), 15-20. https://doi.org/10.11648/j.ijg.20230701.12

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ACS Style

Homa Abri; Farhad Zamani; Mahsa Agahi; Hossein Ajdarkosh; Amirhossein Faraji, et al. Effect of Somatostatin Plus Diclofenac in Comparison with Diclofenac Before ERCP on the Pancreatitis Double Blinded Randomized Clinical Trial. Int. J. Gastroenterol. 2023, 7(1), 15-20. doi: 10.11648/j.ijg.20230701.12

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AMA Style

Homa Abri, Farhad Zamani, Mahsa Agahi, Hossein Ajdarkosh, Amirhossein Faraji, et al. Effect of Somatostatin Plus Diclofenac in Comparison with Diclofenac Before ERCP on the Pancreatitis Double Blinded Randomized Clinical Trial. Int J Gastroenterol. 2023;7(1):15-20. doi: 10.11648/j.ijg.20230701.12

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@article{10.11648/j.ijg.20230701.12,
  author = {Homa Abri and Farhad Zamani and Mahsa Agahi and Hossein Ajdarkosh and Amirhossein Faraji and Mahmoodreza Khoonsari and Elham Sobhrakhshankhah and Nima Motamed and Masoudreza Sohrabi and Fahimeh Safarnezhad Tameshkel and Roghaye Sahraei and Pardis Sadeghipour and Mehdi Nikkhah},
  title = {Effect of Somatostatin Plus Diclofenac in Comparison with Diclofenac Before ERCP on the Pancreatitis Double Blinded Randomized Clinical Trial},
  journal = {International Journal of Gastroenterology},
  volume = {7},
  number = {1},
  pages = {15-20},
  doi = {10.11648/j.ijg.20230701.12},
  url = {https://doi.org/10.11648/j.ijg.20230701.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijg.20230701.12},
  abstract = {Background/Aims: Despite many therapeutic attempts, post-retrograde cholangiopancreatography pancreatitis (PEP) has remained as a major challenge in interventional endoscopy. This study aimed to compare the effects of intravenous somatostatin plus rectal diclofenac with rectal diclofenac alone in the prevention of PEP. Methods: In a double-blind, randomized clinical trial, patients candidate for ERCP who accepted the study protocol were enrolled in the study between 2019 and 2021. The exclusion criteria include a history of pancreatobiliary surgery, ERCP, acute pancreatitis, contraindication, sensitivity to somatostatin, diclofenac, and pregnancy. PEP was defined as abdominal pain with elevated amylase level. Patients who received intravenous somatostatin plus diclofenac and diclofenac alone enrolled in case group and control group respectively. Patients were followed up for 24h after the procedure. Data regarding demographic, clinical presentation and laboratories results were recorded and compared. Results: A total 186 patients were enrolled, 91 in the case group and 95 as controls. There was no statistically significant difference between the two groups in terms of PEP incidence, complications or changes in serum amylase level (p > 0.05). Conclusion: Rectal diclofenac combined with intravenous somatostatin was superior to rectal diclofenac alone to prevent PE, but without a statistically significant difference, which is probably due to the synergic effect of somatostatin and diclofenac.},
 year = {2023}
}

Copy | Download

TY  - JOUR
T1  - Effect of Somatostatin Plus Diclofenac in Comparison with Diclofenac Before ERCP on the Pancreatitis Double Blinded Randomized Clinical Trial
AU  - Homa Abri
AU  - Farhad Zamani
AU  - Mahsa Agahi
AU  - Hossein Ajdarkosh
AU  - Amirhossein Faraji
AU  - Mahmoodreza Khoonsari
AU  - Elham Sobhrakhshankhah
AU  - Nima Motamed
AU  - Masoudreza Sohrabi
AU  - Fahimeh Safarnezhad Tameshkel
AU  - Roghaye Sahraei
AU  - Pardis Sadeghipour
AU  - Mehdi Nikkhah
Y1  - 2023/03/20
PY  - 2023
N1  - https://doi.org/10.11648/j.ijg.20230701.12
DO  - 10.11648/j.ijg.20230701.12
T2  - International Journal of Gastroenterology
JF  - International Journal of Gastroenterology
JO  - International Journal of Gastroenterology
SP  - 15
EP  - 20
PB  - Science Publishing Group
SN  - 2640-169X
UR  - https://doi.org/10.11648/j.ijg.20230701.12
AB  - Background/Aims: Despite many therapeutic attempts, post-retrograde cholangiopancreatography pancreatitis (PEP) has remained as a major challenge in interventional endoscopy. This study aimed to compare the effects of intravenous somatostatin plus rectal diclofenac with rectal diclofenac alone in the prevention of PEP. Methods: In a double-blind, randomized clinical trial, patients candidate for ERCP who accepted the study protocol were enrolled in the study between 2019 and 2021. The exclusion criteria include a history of pancreatobiliary surgery, ERCP, acute pancreatitis, contraindication, sensitivity to somatostatin, diclofenac, and pregnancy. PEP was defined as abdominal pain with elevated amylase level. Patients who received intravenous somatostatin plus diclofenac and diclofenac alone enrolled in case group and control group respectively. Patients were followed up for 24h after the procedure. Data regarding demographic, clinical presentation and laboratories results were recorded and compared. Results: A total 186 patients were enrolled, 91 in the case group and 95 as controls. There was no statistically significant difference between the two groups in terms of PEP incidence, complications or changes in serum amylase level (p > 0.05). Conclusion: Rectal diclofenac combined with intravenous somatostatin was superior to rectal diclofenac alone to prevent PE, but without a statistically significant difference, which is probably due to the synergic effect of somatostatin and diclofenac.
VL  - 7
IS  - 1
ER  -

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