الفهرس 
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Abstract
Summary and Conclusion 113
SUMMARY AND CONCLUSION
The problem of complications of endoscopic retrograde
cholangiopancreatography are widely in between patients undergoing the
procedure allover the whorled including elevation of serum amylase and
serum lipase leading to pancreatic complications in between I - 3% of
the total patients.
Serum amylase and lipase are elevated to the pathological rang in
between most patients in all trials and causing pancreatitis either acute
or chronic.
This study was carried out at El-Maadi Military Hospital,
Department of the internal Medicine, Benha Faculty of Medicine,
Zagazig University and Biochemistry Departments.
The study included (70) subjects of both sexes and different ages.
They were divided into two main groups :
Summary and Conclusion 114
Control group :
Number of 30 subjects from both sexes 19 females and 11 males
with age ranges between 35 - 55 years were included in this group.
All subjects were undergoing the procedure of endoscopic
retrograde cholangiopancreatography (ERCP), also they were examined
clinically, laboratory and radiologically and received only isotonic
sodium chloride.
Patient group :
Also number 40 patients wee included with the same distribution
of ages and sexes, all of them were examined clinically, laboratory and
radiologically before the procedure ERCP.
Each of them were received 0.1 ml of long acting somatostatin
analogue (octreotide acetate-sandostatin) subcutaneously 25 minutes
before and serum amylase and serum lipase levels were measured before
ERCP, 90 minutes and 180 minutes after ERCP.
Patients were followed up for any post ERCP complications
appears.
Summary and Conclusion 115
Ten of these patients were excluded because of:
1. Filling of bile duct only.
2. Incomplete filling of pancreatic duct because of technical failure
or presence of congenital anomaly.
3. Overfilling of the pancreatic duct and acinar opacification of the
gland.
Our results revealed :
1. Serum amylase and lipase enzymes levels were significantly
raised in control group after ERCP 90 minutes and 180 minutes
that level before ERCP and going more.
2. Serum amylase and lipase enzymes levels were also significantly
raised in patients received the octreotide acetate (sandostatin) but
with lower levels than control group 90 minutes and 180 minutes
after ERCP.
3. Light complications as vomiting and abdominal colics in between
patient group were proved after ERCP.
Also, still the question can octreotide acetate (sandostatin) used
as a prophylactic measure for prevention of the pancreatic complications
after ERCP by lowering the enzymatic levels in all patients undergoing
the procedure of ERCP.
We must need further studies in the same subject.
Summary and Conclusion 116
CONCLUSION:
By analysis of results of this study, it become clear that serum
amylase and lipase enzymes levels are elevated to pathological range
among control cases, while ameliorated in patients received octreotide
acetate subcutaneously.
Besides, further studies are needed to compair the elevation of
serum amylase and lipase enzymes level after 180 minutes from ERCP
for detecting the percentage control of octrotide acetate over the
enzymes levels after ERCP and so octreotide can be given in recurrent
dose after three hours from ERCP for decreasing enzymes levels towards
the normal rang and if it can be used as a potent prophylactic measure
before ERCP.