Abstract
The aim of the present study was to evaluate the influence of low-dose perioperative octreotide on the prevention of complications (pancreatic fistula and general complications) in patients undergoing pancreatic surgery followed by pancreaticojejunostomy. A total of 105 patients were randomized to receive either octreotide 0.1 mg subcutaneously 3 times/day for a total of 7 days or no octreotide. The primary endpoints were the occurence of a pancreatic fistula and or general complications, including extended length of hospital stay. There were 25 surgical draining procedures performed and 80 duodenopancreatectomies with or without preservation of the pylorus. In all, 25 (23.8%) of the patients were treated for chronic pancreatitis, 8 (7.6%) for benign tumoral disease, and 72 (68.6%) for carcinoma. All patients underwent pancreaticojejunostomy.
Similar content being viewed by others
References
Van Berge Henegouwen MI, Moojen TM, Van Gulik TM, et al. Postoperative weight gain after standard Whipple’s procedure versus pylorus-preserving pancreatoduodenectomy: the influence of tumor status. Br. J. Surg. l998;85:922–926
Neoptolernos JP, Russell RC, Bramhall S, et al. Low mortality following resection for pancreatic and periampullary tumors in 1026 patients: UK survey of specialist pancreatic units. UK Pancreatic Cancer Group. Br. J. Surg. 1997;84:1370–1376
Trede M, Saeger HD, Schwall G, et al. Resection of pancreatic cancer—surgical achievements. Langenbecks Arch. Surg. 1998;383:121–128
Cameron JL, Pitt HA, Yeo CJ, et al. One hundred and forty-five consecutive pancreaticoduodenectomies without mortality. Ann. Surg. 1993;217:430–435
Yeo CJ, Cameron JL, Sohn TA, et al. Six hundred fifty consecutive pancreaticoduodenectomiesin the 1990s: pathology, complications, and outcomes. Ann. Surg. 1997;226:248–257
Fernandez-del Castillo C, Rattner DW, Warschaw AL. Standards for pancreatic resection in the 1990s. Arch. Surg. 1995;130:295–299
Trede M, Carter DC. The complications of pancreatoduodenectomy and their management. In Trede M, Carter DC, editors Surgery of the Pancreas, Edinburgh, Churchill Livingstone, 1993:629–644
Gouillat C, Chipponit J, Baulieux J, et al. Randomized controlled multicentre trial of somatostatin infusion after pancreaticoduodenectomy. Br. J. Surg.2001;88:1456–1462
Büchler M, Friess H, Klempa, et al. Role of octreotide in the prevention of postoperative complications following pancreatic resection. Am. J. Surg. 1992;l63:125–130
Pederzoli P, Bassi C, Falconi M, et al. Efficacy of octreotide in the prevention of complications of elective pancreatic surgery. Italian Study Group. Br. J.Surg.1994;81:265–269
Lowy AM, Lee JE, Pisters PW, et al. Prospective randomized trial of octreotide to prevent pancreatic fistula after pancreaticoduodenectomy for malignant disease. Ann. Surg. 1997;226:632–641
Yeo CJ, Cameron JL, Lillemoe KD, et al. Does prophylactic octreotide decrease the rates of pancreatic fistula and other complications after pancreaticoduodenectomy? Results of a prospective randomized placebo-controlled trial. Ann. Surg. 2000;232:419–429
Schäfer M, Müllhaupt B, Clavien PA. Evidence-based pancreatic head resection for pancreatic cancer and chronic pancreatitis. Ann. Surg. 2002;236:137–148
Li-Ling J, Irving M . Somatostatin and octreotide in the prevention of postoperative pancreatic complications and the treatment of enterocutaneous pancreatic fistulas: a systematic review of randomized controlled trials. Br. J. Surg. 2001;88:190–199
Friess H, Beger HG, Sulkowski U, et al. Randomized controlled mulicentre study on the prevention of complications by octreotide in patients undergoing surgery for chronic pancreatitis. Br. J. Surg. 1995;82:1270–1273
Suzuki Y, Fujino Y, Tanioka Y, et al. Selection of pancreaticojejunostomy techniques according to pancreatic texture and duct size. Arch. Surg. 2002;137:1044–1047
Büchler W, Friess H, Wagner M, et al. Pancreatic fistula after pancreatic head resection. Br. J. Surg. 2000;87:883–889
Heintges T, Luthen R, Niederau C. Inhibition of exocrine pancreatic secretion by somatostatin and its analogues. Digestion 1994;55:1–9
Acknowledgments
The authors thank MRS. Inge Baeke for secretarial assistance.
Author information
Authors and Affiliations
Corresponding author
Additional information
Present address: Klinikum Stuttgart–Krankenhaus Bad Cannstatt Priessnitzweg 24, D-70374 Stuttgart.
An erratum to this article is available at http://dx.doi.org/10.1007/s00268-005-7996-5.
Rights and permissions
About this article
Cite this article
Hesse, U.J., De Decker, C., Houtmeyers, P. et al. Prospectively Randomized Trial Using Perioperative Low-dose Octreotide to Prevent Organ-related and General Complications after Pancreatic Surgery and Pancreatico-jejunostomy. World J. Surg. 29, 1325–1328 (2005). https://doi.org/10.1007/s00268-005-7546-1
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00268-005-7546-1