Skip to main content
SpringerLink
Log in

Medical Treatment: How and How Long?

  • Conference paper
Facing the Pancreatic Dilemma

  • 55 Accesses

Abstract

Normally, pancreatic secretions are produced by the acinar cells and move in a one way direction through the duct system to the duodenum. If glandular integrity is disrupted, pancreatic exocrine fluid may find another route of egress. There are three potential courses for the fluid to take. It may enter the peritoneal cavity directly and form pancreatic ascites. It may be walled off by surrounding tissue and form a pseudocyst. Finally, it may form a fistulous tract that terminates either internally or externally. This report reviews the medical management of external pancreatic fistulas.

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

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Zinner MJ, Baker RR, Cameron JL (1974) Pancreatic cutaneous fistulas. Surg Gynecol Obstet 138:710–712

    PubMed  CAS  Google Scholar 

  2. Kellum JM, Holland GF, McNeill P (1988) Traumatic pancreatic fistula: comparison of enterai and parenteral feedings. J Trauma 28:700 – 704

    Article  PubMed  CAS  Google Scholar 

  3. Martin FM, Rossi RL, Munson JL, ReMine SG, Braasch JW (1989) Management of pancreatic fistulas. Arch Surg 124:571–573

    Article  PubMed  CAS  Google Scholar 

  4. Pederzoli P, Bassi C, Falconi M, Albrigo R, Vantini I, Micciolo R (1986) Conservative treatment of pancreatic fistulas with parenteral nutrition alone or in combination with continuous infusion of somatostatin, glucagon or calcitonin. Surg Gynecol Obstet 163 : 428–432

    PubMed  CAS  Google Scholar 

  5. Baker RJ, Bass RT, Zajtchuk R, Strohl EL (1967) External pancreatic fistula following abdominal injury. Arch Surg 95:556 – 566

    Article  PubMed  CAS  Google Scholar 

  6. Anderson MD, Mueller JM, Snyder DO (1960) Depression of pancreatic exocrine secretion with a carbonic anhydrase inhibitor. Am J Dig Dis 5:714–723

    Article  PubMed  CAS  Google Scholar 

  7. Craft CB (1938) The effect of ephedrine on pancreatic secretion: a method for the management of patients having pancreatic fistula. Surgery 4:64–73

    CAS  Google Scholar 

  8. Joehl RJ, Nahrwold DL (1985) Inhibition of human pancreatic secretion by terbutaline as a potential agent for treating patients with pancreatic fistula. Surg Gynecol Obstet 160: 109–114

    PubMed  CAS  Google Scholar 

  9. Fallingborg J, Anderson SP, Laustsen J, Christensen LA (1986) Glucagon treatment of external pancreatic fistula. Acta Chir Scan 151:183 –184

    Google Scholar 

  10. Garcia-Puges AM, Navarro S, Fernandez-Cruz L, Ros E, Hinojosa L, Pera C (1988) Oral pancreatic enzymes accelerate closure of external pancreatic fistulae. Br J Surg 751924–925

    Article  PubMed  CAS  Google Scholar 

  11. Morris SJ, Barkin JS, Kaiser MH, Haas MF (1979) Radiation therapy of a pancreatic fistula. Am J Gastroenterol 72:431 – 433

    PubMed  CAS  Google Scholar 

  12. Ahren B, Tranberg KG, Bengmark S (1988) Treatment of pancreatic fistula with the somatostatin analogue SMS 201 – 995. Br J Surg 75:718

    Article  PubMed  CAS  Google Scholar 

  13. Barnes SM, Kontny BG, Prinz RA (1993) Somatostatin analog treatment of pancreatic fistulas. Int J Pancreatol 14:181 –188

    PubMed  CAS  Google Scholar 

  14. de Bois MH, Bosman CH, de Graaf P, van Hoogenhuijze J (1988) Closure of a high-output external pancreatic fistula by SMS 201–995, a long-acting analogue of somatostatin. Neth J Med 32:293 – 297

    PubMed  Google Scholar 

  15. Kwan D, Aufses AH (1989) Short-term administration of SMS 201 – 995 in the management of an external pancreatic fistula. Am J Gastroenterol 84:326–328

    PubMed  CAS  Google Scholar 

  16. Lansden FT, Adams DB, Anderson MC (1989) Treatment of external pancreatic fistulas with somatostatin. Am Surg 55:695 – 698

    PubMed  CAS  Google Scholar 

  17. Prinz RA, Pickleman J, Hoffman JP (1988) Treatment of pancreatic cutaneous fistula with a somatostatin analog. Am J Surg 155:36–42

    Article  PubMed  CAS  Google Scholar 

  18. Doubilet H, Fishman L (1961) Human biliary-pancreatic secretion. Am J Gastroent 35:499

    PubMed  CAS  Google Scholar 

  19. Sinclair ISR (1956) Observations on a case of external pancreatic fistula in man. Br. J Surg 44:250

    Article  PubMed  CAS  Google Scholar 

  20. Birnbaum D, Hollander F (1952) Inhibition of pancreatic secretion by the carbonic anhydrase inhibitor, 2-acetylamino-1,3,4-thiazol-5-sulfonamide. Proc Soc Exp Biol Med 81:23

    PubMed  CAS  Google Scholar 

  21. Papastrat CJ, Miller JM (1958) Treatment of external pancreatic fistula with diamox. Am J Dig Dis 3:399

    Article  PubMed  CAS  Google Scholar 

  22. Watman RN (1956) The inhibition of human pancreatic secretion by carbonic anhydrase inhibitor. Surgery 39:337

    PubMed  CAS  Google Scholar 

  23. Rudick J, Gonda M, Rosenberg IR et al. (1973) Effects of a beta-adrenergic receptor stimulant (isoproterenol) on pancreatic exocrine secretion. Surgery 74:338–343

    PubMed  CAS  Google Scholar 

  24. Joehl RJ, Nahrwold DL (1985) Inhibition of human pancreatic secretion by terbutaline as a potential agent for treating patients with pancreatic fistula. Surg Gynecol Obstet 160: 109–114

    PubMed  CAS  Google Scholar 

  25. Knight MJ, Condon JR, Smith R (1971) Possible use of glucagon in the treatment of pancreatitis. Br J Med 2:440

    Article  CAS  Google Scholar 

  26. Fallingborg J, Andersen SP, Laustsen J, Christensen LA (1985) Glucagon treatment of external pancreatic fistula. Acta Chir Scand 151:183–184

    PubMed  CAS  Google Scholar 

  27. Hughes RG, Cooper MJ, Wiliamson RCN (1983) Conservative management of post-traumatic pancreatic fistula. Scand J Gastroenterol 18 [Suppl 87] : 103

    Google Scholar 

  28. Owyang CS, Louie D, Tatum D (1986) Feedback regulation of pancreatic enzyme secretion. Supression of cholecystokinin release by trypsin. J Clin Invest 77:2042–2047

    Article  PubMed  CAS  Google Scholar 

  29. Reichlin S (1983) Somatostatin. N Engl J Med 309:1556 –1563

    Article  PubMed  CAS  Google Scholar 

  30. Conway DR, Djuricin G, Prinz RA (1988) The effect of somatostatin analogue (SMS 201–995) on pancreatic blood flow. Surgery 104 (6) 11024–1030

    Google Scholar 

  31. Hild P, Stoyanov M, Dobroschke J, Aigner K (1982) La somatostatine dans le traitement medical des distules du pancreas et de l’intestin grele. Ann Cir 36 (3) : 193 –196

    CAS  Google Scholar 

  32. Cavagni F, Pinto M, Castagna L (1984) Protracted administraton of somatostatin to patients with pancreatic fistulas: clinical and endocrine evaluation. In: Angelini L, Usadel KM (eds) Therapeutic effects of somatostatin. Scrono Symposia Reviews, Rome, pp 157–165

    Google Scholar 

  33. Bauer W, Briner U, Doepfner W, Haller R, Huguenin R, Marbach P, Betcher TJ, Pless J (1982) SMS 201–995: a very potent and selectiveoctapeptide analogue of somatostatin with prolonged action. Life Sci 31:1133–1140

    Article  PubMed  CAS  Google Scholar 

  34. Ellison EC, O’Dorisio TM, Lott J, Beaver B, Cloutier CT, Carey LC (1985) The effect of long-acting somatostatin analog (SMS 201–995) on basal pancreatic exocrine secretion in man. Gastroenterology 88:1373 –1374

    Google Scholar 

  35. Williams ST, Weltering EA, O’Dorisio TM, Fletcher WS (1989) Effect of octreotide acetate on pancreatic exocrine funtion. Am J Surg 157:459–462

    Article  PubMed  CAS  Google Scholar 

  36. Altimari AF, Bhoopalam N, O’Dorisio T, Lange CL, Sandberg L, Prinz RA (1986) Use of a somatostatin analog (SMS 201–995) in the glucagonoma syndrome. Surgery 100:989 – 996

    PubMed  CAS  Google Scholar 

  37. Lotti VJ, Pendleton RG, Gould RJ, Hanson HM, Chang SL, Clineschmidt BC (1987) In vivo pharmacology of L-364, 718, a new potent non peptide peripheral cholecystokinin antagonist. J Pharmacol Exp Ther 241:103 –109

    PubMed  CAS  Google Scholar 

Download references

Authors
  1. R. A. Prinz
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Surgery, University of Verona Borgo Roma Hospital, I-37134, Verona, Italy

    Paolo Pederzoli M. D. (Prof.), Giorgio Cavallini M. D. (Prof.), Claudio Bassi M.D.  & Massimo Falconi M.D. (Prof.),  (Prof.),  & 

Rights and permissions

Reprints and permissions

Copyright information

© 1994 Springer-Verlag Berlin Heidelberg

About this paper

Cite this paper

Prinz, R.A. (1994). Medical Treatment: How and How Long?. In: Pederzoli, P., Cavallini, G., Bassi, C., Falconi, M. (eds) Facing the Pancreatic Dilemma. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-79167-3_38

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-79167-3_38

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-58284-7

  • Online ISBN: 978-3-642-79167-3

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation