Octreotide prophylaxis is not beneficial for biochemical activity and clinical severity of postoperative pancreatic fistula after pancreatic surgery.

Abstract

BACKGROUND:

Prospective randomized trials indicate that prophylactic octreotide treatment does not decrease the incidence of postoperative pancreatic fistula (POPF). The aim of this study was to analyze if octreotide prophylaxis could decrease the severity grade of POPFs after pancreatic surgery.

METHOD:

Seventy-eight of 684 patients undergoing pancreatic resection with POPF were included in the study. Prophylactic octreotide treatment was started immediately after surgery and was performed in 22 patients, whereas 56 patients had no octreotide treatment and served as controls. Lipase activity was measured in the abdominal drainage on postoperative days (POD) 3, 5 and 7. Primary endpoints of the study were clinical severity of the POPF and lipase activity in the drainage.

RESULTS:

There was no significant difference concerning length of postoperative hospital stay. Lipase activity in the abdominal drainage was not influenced by octreotide prophylaxis at POD 5 or 7 compared to POD 3. Multivariate analysis showed that the risk to develop a type B or C fistula in the octreotide group was independent of the kind of operation and the consistency of the pancreas (RR = 3.4; CI = 1.0-11.7; p = 0.050 and RR = 6.3; CI = 1.4-29.6; p = 0.019).

CONCLUSION:

Octreotide prophylaxis after pancreatic surgery has no beneficial effect on clinical severity of POPF.

• Authors: R A Droeser, P Jeanmonod, J Schuld, M R Moussavian, M K Schilling, O Kollmar
• Journal: Digestive surgery (Dig Surg) Vol. 29 Issue 6 Pg. 484-91 ( 2012) ISSN: 1421-9883 [Electronic] Switzerland
• PMID: 23392293 (Publication Type: Evaluation Study, Journal Article)
• Copyright: Copyright © 2012 S. Karger AG, Basel.

Chemical References

• Biomarkers
• Gastrointestinal Agents
• Lipase
• Octreotide

Topics

• Aged
• Biomarkers (metabolism)
• Drug Administration Schedule
• Female
• Gastrointestinal Agents (therapeutic use)
• Humans
• Kaplan-Meier Estimate
• Length of Stay (statistics & numerical data)
• Lipase (metabolism)
• Logistic Models
• Male
• Middle Aged
• Multivariate Analysis
• Octreotide (therapeutic use)
• Pancreatectomy
• Pancreatic Fistula (etiology, metabolism, prevention & control)
• Pancreaticoduodenectomy
• Postoperative Care (methods)
• Postoperative Complications (etiology, metabolism, prevention & control)
• Retrospective Studies
• Risk Factors
• Severity of Illness Index
• Treatment Outcome