Effect of Somatostatin Analog Octreotide on Sphincter of Oddi Motility: A Biliary Manometric Study

Park, Young Sook; Kim, Jin Hong; Moon, Young Soo; Kim, Young Soo; Hahm, Ki Baik; Cho, Sung Won; Lee, Sang In

Abstract

BACKGROUND AND AIMS: Sotnatostatin and its long-acting analog octreotide have been found to exert a spectrum of activities on the biliary tract. Animal and clinical studies have shown inhibition of gallbladder contraction, bile secretion, and bile flow. The aim of this study was to investigate the effect of the long-acting somatostatin analog octreotide on the sphincter of Oddi motility.
METHODS
16 patients (no pancreato-biliary disease in 5 patient.;, gallstones in 9 patients, and biliary cancer in 2 patients, GB cancer and klatskin tumor respectively) underwent endoscopic retrograde cholangiopancreatography and performed endoscopic sphincter of Oddi (SO) manometry with a triple-lumen low-compliance system before and after intravenous administration of octreotide in a dose of 50pg.
RESULTS
There was no significant difference of basal SO pressure, amplitude and frequency of phasic contraction between the patients with no pancreatobiliary disease, gall stones, and biliary cancer, In all of the 16 patients, the basal SO pressure, amplitude and frequency of phasic contraction were 21.9+/-15.9 mmHg, 113.7+/-44.2 mmHg, and 3.4+/-1,6/min, respectively. After administration of octreotide, a mean of latent period was 59 seconds and a mean of action duration was 152 seconds. The basal SO pressure and the frequency of phasic contraction were significantly increased to 46.6+/-20.3 mmHg and 8.8+/-2.3/min (p<0.05) and the amplitude of phasic contraction was significantly decreased to 69.8+/-31.7 mmHg (p<0.05). The mean of duration of phasic contraction and propagation direction of phasic cantraction were not significantly influenced.
CONCLUSIONS
These results demonstrated that octreotide had a significant stimulatory effect on the sphincter of Oddi activity, which may irnpair biliary and pancreatic flow.