Skip to main content
Log in

Octreotide administration in the treatment of pancreatic fistulae after pancreas transplantation

  • Original Articles
  • Published:
Transplant International

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. 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

    Google Scholar 

  2. 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

    Google Scholar 

  3. 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

    Google Scholar 

  4. 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

    Google Scholar 

  5. 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

    Google Scholar 

  6. Kaneko T, Oka H, Munemura M (1974) Radioimmunoassay of human proinsulin C peptide using synthetic human connecting peptide. Endrocrinol Jpn 21:141–143

    Google Scholar 

  7. 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

    Google Scholar 

  8. 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

    Google Scholar 

  9. Mahoney WC, Orf JW (1985) Derivatives of cyclosporin compatible with antibody based assay: the generation of (125I) labeled cyclosporin. Clin Chem 31:459–463

    Google Scholar 

  10. 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

    Google Scholar 

  11. 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

    Google Scholar 

  12. 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

    Google Scholar 

  13. 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

    Google Scholar 

  14. Schran HF, Rosano TG, Hassel AE, Pell MA (1987) Determination of cyclosporin concentration with monoclonal antibodies. clin Chem 33: 2225–2230

    Google Scholar 

  15. Sollinger HW, Stratta RJ, Kalayoglu M, Pirsch JD, Belzer FO (1987) Pancreas transplantation with pancreaticocystostomy and quadruple immunosuppression. Surgery 102: 674–679

    Google Scholar 

  16. 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

    Google Scholar 

  17. 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

  18. Sutherland DER, Chow SY, Moudry-Munns KC (1989) International pancreas registry report 1988. Clin Transplant 3: 129–149

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

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

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00336070

Key words

Navigation