Comparative Effectiveness of Somatostatin and Octreotide for Preventing Pancreatitis After Endoscopic Retrograde Cholangiopancreatography: A Retrospective Study

BACKGROUNDS: Endoscopic retrograde cholangiopancreatography (ERCP) is a diagnostic and therapeutic procedure for biliary and pancreatic diseases. Post-ERCP pancreatitis (PEP) is a common complication. The efficacy of somatostatin and octreotide for PEP prevention is controversial. This study aimed to compare somatostatin and octreotide formulations for PEP prevention. METHODS: A retrospective trial analyzed patients undergoing ERCP, stratified by medication type and dosage. The primary outcome was PEP incidence. Secondary outcomes included hyperamylasemia incidence, the duration of hospitalization due to pancreatitis, and postoperative pancreatic function. Post-ERCP complications and adverse events were recorded to evaluate safety. RESULTS: A total of 191 patients undergoing 202 ERCP procedures were analyzed. The overall incidences of PEP and hyperamylasemia were 12.4% and 10.9%, respectively. There was no significant difference in PEP incidence between the somatostatin and octreotide groups (13.1% vs. 9.7%, p > 0.05). PEP incidence was significantly lower in the high-dose somatostatin group compared to the low-dose group (1.8% vs. 20%, p < 0.05), and in the high-dose octreotide group compared to the low-dose group (0.0% vs. 18.8%, p < 0.05). No significant differences in hyperamylasemia rates, post-ERCP amylase and lipase levels, duration of hospitalization due to pancreatitis, complications, and adverse events were observed across groups. CONCLUSION: High-dose somatostatin (at least 6 mg) or octreotide (at least 0.5 mg) within 24 h after ERCP are suggested for preventing PEP in patients at average risk.