Pancreatitis is the most common and serious complication of ERCP. On the basis of several reports, corticosteroid, octreotide, or calcium channel blocker might be effective in this regard. The aim of this study was to determine whether the phamacologic agents(steroid, variable amount of octreotide, and verapamil) prevent post-ERCP pancreatitis.

A total of 80 patients were randomized. All patients received intravenously gabexate mesilate(Foy®) before endoscopy. Group 1 has been dose of octreotide (0.2mg blous and 6mg intravenous infusion) in group 3, and verapamil in group 4. Clinical outcomes and risk factors were analysed in each groups. We checked cytokines (IL-1, TNF-α) in group 3 and 4 compared with control and alcohol induced pacreatitis.

The overall frequency of hyperamylasemia and pancreatitis were 35% (28/80) and 13.7% (11/80), respectively. There was no difference among 4 groups with the incidence and severity of pancreatitis. The groups were similar with regard to demographic characteristics, type of procedure performed(diagnostic or therapeutic), the presence of diverticulum, visualization of pancreatic duct. There was no risk factors of ERCP-pancreatitis in all groups. In the cytokine data, TNF-α was markedly decreased on right after ERCP in patients with hyperamyasemia and pancreatitis.

Prophylactic administered corticosteroid, octredtid, or verpamil would not be helpful for prevention in post-ERCP pancreatitis. Also IL-1 and TNF-α may not be useful markers in prediction of ERCP-pancretitis. But TNF-α would be useful marker as mild form ERCP-pancreatitis and alcoholic pancreatitis.

Pancreatitis is the most common and serious complication of diagnostic and therapeutic ERCP. On the basis of several reports, corticostroid or octreotide might be effective in this regard. The aim of this study was to determine whether the pharmacologic agents(stroid and octreotide) prevent post-ERCP pancreatitis.

Patients received an intravenous infusion of hydrcortisone(100mg) and octreotide (0.2mg bolus) in treated group Tmmediately before endoscopy. A total of 140 patients(73men and 67 women, with an average age of 61.5 yr) who were scheduled to undergo diagnostic or therapeutic ERCP. Nine patients were excluded from the final evaluation for incomplete records. The remaining 131 patients, 61 in the treated group and 70 in the control group, were analyzed.

The overall frequency of hyperamylasmia and pancreatitis were 33.6%(44/131) and 7.6%(10/131), respectively. The all pancreatitis were mild. There was no difference between the groups with the incidence and severity of pancreatitis. The procedure-induced pancreatitis occured in 5 of 61(8.2%) patients treated with hydrocortisone and octreotide and 5 of 70(7.2%) patients in the control group(p=ns). the groups were similar with regard to desmographic characteristics, type of procedure performed(diagnostic or therapeutic), the presence of diverticulum, visualization of pancreatic duct. The only risk factor of ERCP-pancreatitis is the visualization of pancreatic duct in both groups.

Prophylactic administered corticosteroid and octreotide did not prevent of post-ERCP pancreatitis. Pancreatic injury may be only related to maneuver of pancreatic duct.