Prophylactic Octreotide Administration Does Not Prevent Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis

Objectives: There is no consensus whether octreotide can prevent post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis. We pet-formed a meta-analysis comparing octreotide with placebo in randomized controlled trials. Methods: Electronic databases, including MEDLINE, EMBASE, Cochrane controlled trials register, the Cochrane Library, and the Science Citation Index updated to January 2007, were searched to retrieve relevant randomized controlled trials. Outcome measures were post-ERCP pancreatitis. Results: Fifteen trials were identified, and statistical homogeneity was present among these selected trials. After all the trials were pooled, post-ERCP pancreatitis occurred in 7.0% of controls (92 of 1320) versus 5.5% of treated patients (72 of 1301), without statistical significance (odds ratio, 0.78; 95% confidence interval, 0.57-1.08). Subsequent sensitivity analyses and subgroup analyses also produced no significant effect. Only in large-scale trials (>200 cases) that octreotide could statistically, significantly prevent pancreatitis (odds ratio, 0.50; 95% confidence interval, 0.32-0.79). Conclusions: On the basis of current best evidence, octreotide cannot prevent post-ERCP pancreatitis.