Abstract
Among the surgical complications of pancreas transplantation are pancreatic fistulae, which arise rather frequently. Suppression of exocrine secretion with polymers has succeeded in reducing the rate of this complication. Nevertheless, in some instances, pancreatic fistulas may occur. Thirty pancreas transplantations were performed in 27 diabetic patients. In 5 cases a pancreatic fistula occurred and was drained after the insertion of a catheter for the collection of secretions. A serous liquid was collected with a high concentration of amylases (61604±19562 IU/24h). Fistula output was 280 ±87 ml/24 h. Patients were treated with octreotide, administered subcutaneously in a dose of 300–750 μg/day. In all patients a progressive reduction in fistula output was observed after a mean of 16+2 days. Fistula flow rate dropped to 24±10 ml/24 h-areduction of 95%±5% and drainage was subsequently stopped. Sonographic followup did not show recurrence of peripancreatic collections in these patients. All patients were insulin-independent up to 12–44 months after surgery.
Similar content being viewed by others
References
Bauer W, Briner V, Doepfner W (1982) SMS 201 995: a very potent and selective octapeptide analogue of somatostatin with prolonged action. Life Sci 31:113–115
Burke GW, Gruessner R, Dunn DL, Sutherland DER (1990) Conversion of whole pancreaticoduodenal transplants from bladder to enteric drainage for metabolic acidosis or dysuria. Transplant Proc 22:651–652
Cooper MM, Wright FH, Smith JL, Corry RJ (1989) Successful treatment of a high-output fistula with a somatostatin analogue following pancreas transplantation. Transplant Proc 21:3738–3741
Corry RJ, Nghiem DD, Schulak JA, Beutel WD, Gonwa TA (1986) Surgical treatment of diabetic nephropathy with simultaneous pancreatic duodenal and renal transplantation. Surg Gynecol Obstet 162:547–555
Dubernard JM, Traeger J, Neyra P, Touraine JL, Tranchant D, Blanc Brunat N (1978) New method of preparation of a segmental pancreatic graft for transplantation: trials in dogs and in man. Surgery 84:633–639
Kaneko T, Oka H, Munemura M (1974) Radioimmunoassay of human proinsulin C peptide using synthetic human connecting peptide. Endrocrinol Jpn 21:141–143
Landgraf R, Landgraf-Leurs MMC, Nusser J, Hillebrandt G, Illner WD, Abendroth D, Land W (1987) Effect of somatostatin analogue (SMS 201-995) on cyclosporine levels. Transplantation 44:724–725
Lin T, Sutherland DER, Chinn PL, Najarian JS (1985) Effects of a cyclic hexapeptide analog (L363.586) of somatostatin on the function of pancreas grafts in dogs. J Surg Res 39:39–42
Mahoney WC, Orf JW (1985) Derivatives of cyclosporin compatible with antibody based assay: the generation of (125I) labeled cyclosporin. Clin Chem 31:459–463
Melandri M, Lefrancois N, LaRocca E, Martin X, Sanseverino R, Camozzi L, Faure JL, Secchi A, Gelet A, Bottani G, Touraine JL, Pozza G, Dubernard JM (1988) Clinical experience in pancreas transplantation in Lyon: long-term survival of duct injected pancreatic grafts. Acta Diabetol 25:69–80
Mihara S, Yanaihara C, Nishiura M, et al (1982) Development of pancreatic glucagon specific radioimmunoassay with use of synthetic human glucagon (1929) as immunogen. Radioisotopes 31: 240–244
Nicholson CP, Barr D, Oeltjen MR, Munn SR, DiMagno EP, Carpenter HA, Sarr MG, Perkins JD (1991) The effect of somatostatin 201 995 on the early course of porcine pancreaticoduodenal allotransplantation. Transplant Proc 23: 1587–1588
Rosemberg L, Dafoe DC, Schwartz R, Campbell DA, Turcotte JG, Tsai ST, Vinik A (1987) Administration of somatostatin analog (SMS 201-995) in the treatment of a fistula occurring after pancreas transplantation. Transplantation 43: 764–766
Schran HF, Rosano TG, Hassel AE, Pell MA (1987) Determination of cyclosporin concentration with monoclonal antibodies. clin Chem 33: 2225–2230
Sollinger HW, Stratta RJ, Kalayoglu M, Pirsch JD, Belzer FO (1987) Pancreas transplantation with pancreaticocystostomy and quadruple immunosuppression. Surgery 102: 674–679
Spillenaar Bilgen EJ, Marquet RL, Baumgartner D, Bruin RWF de, Lamberts SWJ, Jeekel J (1989) Attempts to reduce posttransplant pancreatitis in rats and dogs with the somatostatin analogue SMS 201-995. Transplant Proc 21: 2829–2830
Stratta RJ, Taylor RJ, Omaha NE (1992) Selective use of sandostatin in vascularized pancreas transplantation (PT) (abstract). 3rd International Congress on Pancreatic Transplantation, 6–8 June 1992, Lyon, France, p 74
Sutherland DER, Chow SY, Moudry-Munns KC (1989) International pancreas registry report 1988. Clin Transplant 3: 129–149
Author information
Authors and Affiliations
About this article
Cite this article
Secchi, A., Di Carlo, V., Martinenghi, S. et al. Octreotide administration in the treatment of pancreatic fistulae after pancreas transplantation. Transplant Int 5, 201–204 (1992). https://doi.org/10.1007/BF00336070
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00336070