Use of somatostatin in the treatment of digestive fistulas. Pharmacoeconomic issues.
The management of high-cost surgical patients with digestive fistulas is a major health problem. Second to total parenteral nutrition, somatostatin has been considered the most dramatic advance in the control of fluid, electrolyte and nutritional embarrassment caused by such fistulas. Native somatostatin, first isolated in 1973, is a 14-amino acid peptide with a half-life of 1-3 min, and numerous inhibitory effects on the secretion of digestive fluids. Several nonrandomized trials have shown that somatostatin enhances the closure rate and reduces the time to closure of almost all types of digestive fistulas. Somatostatin, if used appropriately, seems to be associated with overall cost savings mainly by decreasing the length of hospital stay. Prospective controlled trials are expected to confirm these findings in the near future.
Fagniez
P L
PL
Service de Chirurgie Digestive, Hôpital Henri-Mondor, Créteil, France. fagniez@hmn.ap-hop-paris.fr
Yahchouchy
E
E
D017046:Cost Savings; D003362:Cost-Benefit Analysis; D016154:Digestive System Fistula / Q000188:drug therapy*; D017850:Economics, Pharmaceutical; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D013004:Somatostatin / Q000191:economics* / Q000627:therapeutic use
D013004:Somatostatin