Clinical observation of octreotide combined with diclofenac sodium in preventing ERCP-related pancreatitis.

ABSTRACT

OBJECTIVE: To elucidate the efficacy of octreotide in combination with diclofenac sodium in the prevention of ERCP-related pancreatitis, and investigate its impact on patients' serum amylase, white blood cell (WBC) count, adverse effects, hyperamylasemia and hemorheology. METHODS: The prospective study was conducted, in which 124 patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) in our hospital were evenly divided into 2 groups, the observation group (n=62) and the control group (n=62), via a random number table method. The control group was administered diclofenac sodium lidocaine hydrochloride via injection after ERCP, while the observation group was given octreotide acetate on the basis of the control group. The incidence of pancreatitis, serum amylase level, WBC count, incidence of adverse effects and hyperamylasemia, and hemorheology levels were compared between these two groups of patients. RESULTS: The incidence of pancreatitis in the observation group was significantly lower than that in the control group (P<0.05). After treatment, the serum amylase level at 24 h post-surgery in the observation group was notably lower than that in the control group (P<0.001). The WBC count at 2 h and 24 h post-surgery in the observation group were both significantly lower than those in the control group (all P<0.001). The incidence of total adverse reactions in the observation group was remarkably lower than that in the control group (P<0.01). The incidence of hyperamylasemia in the observation group was considerably lower than that in the control group (P<0.001). Twenty-four hours post-surgery, the whole blood viscosity at high shear rate, whole blood viscosity at low shear rate, and plasma viscosity in the observation group were all significantly lower than those in the control group (all P<0.001). CONCLUSION: The combination of octreotide and diclofenac sodium could effectively prevent the occurrence of ERCP-related pancreatitis, which reduced the incidence of hyperamylasemia, decreased the WBC count and serum amylase level, improved the hemorheology, and lowered the incidence of adverse effects in patients after ERCP. Therefore, this therapeutic strategy is worthy of clinical propagation and application.