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Perioperative application of somatostatin analogs for pancreatic surgery—current status in Germany

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Abstract

Background

The most common major complication after pancreatic resection is the postoperative pancreatic fistula (POPF). Somatostatin analogs can reduce POPF, but the use of somatostatin analogs is still controversial. The aim of this study was to assess treatment algorithms for pancreatic surgery in Germany with a special focus on the application of somatostatin analogs.

Methods

A questionnaire evaluating the perioperative management–especially the use of somatostatin analogs—and postoperative complications after pancreatic surgery was developed and sent to 209 German hospitals performing >12 pancreatoduodenectomies per year (the requirement for certification as a pancreas center). Statistical analysis was carried out using SPSS 21.

Results

The final response rate was 77 % (160/209), 14.5 % of hospitals never, 37 % always, and 45 % occasionally apply somatostatin analogs after pancreatic surgery. A (standard) drug of choice was defined in 64 % of hospitals. When standard and occasional usage was analyzed, it appeared that hospitals favored somatostatin (69 %) > sandostatin (50 %) > pasireotide (5 %). A relation between the usage of the different somatostatin analogs and morbidity (POPF) or mortality (84 and 16 % of hospitals reported <5 and 5–10 %, respectively) was not seen. Eighty-seven percent of hospitals were interested in participating in future studies analyzing somatostatin use.

Conclusion

This is the first national survey in Germany evaluating the perioperative application of somatostatin analogs for pancreatic surgery. Despite controversial results in the literature, the majority of German pancreas surgeons apply somatostatin analogs perioperatively. The ideal drug to reduce POPF is still unclear. This uncertainty has aroused significant interest and prompted surgeons to participate in future studies in order to elucidate this issue.

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Abbreviations

DKG:

Deutsche Krebsgesellschaft (German Cancer Association)

DGAV:

Deutsche Gesellschaft für Allgemein- und Viszeralchirurgie (German Association for General and Visceral Surgery)

POPF:

Postoperative pancreatic fistula

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Author contributions

Andreas Volk: study design, data acquisition, data analysis, data interpretation, drafting of the manuscript.

Philipp Nitschke: study design, data acquisition, data analysis, data interpretation, manuscript revision.

Franziska Johnscher: data analysis, data interpretation, manuscript revision.

Nuh Rahbari: data acquisition, data analysis, manuscript revision.

Thilo Welsch: study design, data interpretation, manuscript revision.

Christoph Reissfelder: study design, data interpretation, manuscript revision.

Juergen Weitz: study design, data interpretation, manuscript revision.

Marius Distler: study design, data analysis, data interpretation, drafting of the manuscript.

Soeren Torge Mees: study design, data acquisition, data analysis, data interpretation, drafting of the manuscript.

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Authors and Affiliations

  1. Department of Visceral, Thoracic and Vascular Surgery, University Hospital, Fetscherstraße 74, 01307, Dresden, Germany

    Andreas Volk, Philipp Nitschke, Franziska Johnscher, Nuh Rahbari, Thilo Welsch, Christoph Reißfelder, Jürgen Weitz, Marius Distler & Soeren Torge Mees

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  1. Andreas Volk
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Correspondence to Soeren Torge Mees.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Andreas Volk and Philipp Nitschke contributed equally to this study.

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Volk, A., Nitschke, P., Johnscher, F. et al. Perioperative application of somatostatin analogs for pancreatic surgery—current status in Germany. Langenbecks Arch Surg 401, 1037–1044 (2016). https://doi.org/10.1007/s00423-016-1502-4

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