Is octreotide a new hope for enterocutaneous and external pancreatic fistulas closure?
BACKGROUND
Octreotide is a long-acting analogue of somatostatin that exhibits good subcutaneous absorption. It reduces gastrointestinal and pancreatic secretions as well as relaxes the intestinal musculature. It has been hypothesized that octreotide could decrease fistula output, thus facilitating fluid and electrolytes management and possibly hasten fistula closure.


METHODS
Relevant articles were identified from a MEDLINE search of the literature. Because of the scarcity of well-designed studies on the use of octreotide to promote enterocutaneous and pancreaticocutaneous fistulas closure, all case series and controlled trials were reviewed.


CONCLUSIONS
Octreotide as an adjuvant to standard fistula management diminishes fistula output, but its shortening of the time to fistula closure remains to be proven by well-designed comparative trials. For recent onset fistulas (less than 8 days old), octreotide does not seem better than the recommended management, including parenteral nutrition. Octreotide can effectively prevent postoperative complications and fistula formation in patients undergoing elective pancreatic resection.
Martineau
P
P
Faculté de Pharmacie, University of Montreal, Quebec, Canada.
Shwed
J A
JA
Denis
R
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D017577:Cutaneous Fistula / Q000188:drug therapy; D016572:Cyclosporine / Q000493:pharmacokinetics / Q000494:pharmacology; D004347:Drug Interactions; D006728:Hormones / Q000627:therapeutic use*; D006801:Humans; D008875:Middle Aged; D015282:Octreotide / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D010185:Pancreatic Fistula / Q000188:drug therapy*
D006728:Hormones; D016572:Cyclosporine; D015282:Octreotide