Abstract: Objective  To study the effect of somatostatin combined with indomethacin suppository in reducing the incidence of pancreatitis after endoscopic retrograde cholangiopancreatography(ERCP) for cholangiocarcinoma.
Methods  A total of 160 patients with cholangiocarcinoma treated by ERCP were randomly selected as the study subjects, and divided into four groups according to random number table method, with 70 patients in each group. ERCP was performed in all patients. Group A was given somatostatin, group B was given indomethacin, group C was given somatostatin combined with indomethacin, and group D did not receive any of the above treatment. The incidence of acute pancreatitis and hyperamylaseemia after ERCP, as well as the levels of serum amylase(AMS), lipase(LPS) and white blood cell(WBC) at 5 h and 24 h after operation, was compared among the four groups.
Results  The incidence of postoperative pancreatitis in groups A, B and C was lower than that in group D(P＜0.05), and the incidence in group C was lower than that in groups A and B(P＜0.05). There was no statistical significance in the incidence between groups A and B(P＞0.05). No significant difference was noted in the incidence of hyperamylasemia among groups A, B and C(P＞0.05), which, however, was lower than that in group D. There was no statistical significance in both AMS and LPS among groups A, B, C and D before surgery(P＞0.05). At 5 h and 24 h after operation, there were no statistically significant differences between group A and B(P＞0.05); there were statistically significant differences between any other two groups(P＜0.05), that is, the levels of AMS and LPS in groups A, B and C were lower than those in group D, while the levels in group C were lower than those in group A and B. There was no significant difference in WBC indexes between groups A, B, C and D before and at 5 h after operation(P＞0.05). At 24 h after surgery, there was no statistically significant difference between group A and group B(P＞0.05); there was statistically significant difference between any other two groups(P＜0.05), that is, the WBC level of groups A, B and C was lower than that of group D, and the level of group C was lower than that of group A and group B.
Conclusion  The combination of somatostatin and indomethacin suppository can significantly reduce the incidence of pancreatitis after ERCP for cholangiocarcinoma.

Key words: bile duct neoplasms, somatostatin, indomethacin, cholangiopancreatography, endoscopic retrograde