Role of octreotide in the treatment of external pancreatic pure fistulas: a single-institution prospective experience.
BACKGROUND
Octreotide was studied in the treatment of pure external pancreatic fistulas.


METHODS
Eighteen cases (12 males, 6 females) were prospectively observed. Six patients (four after radical surgery for periampullary cancer, one endocrine tumor enucleation and one pancreojejunostomy in chronic pancreatitis) were treated as outpatients with octreotide alone because of low basal fistula output (mean+/-SD: 96.6+/-27.4 cc/24 h). Twelve (five radical surgery for cancer, five surgery for severe pancreatitis, one enucleation and one pancreojejunostomy) were treated as inpatients with octreotide plus total parenteral nutrition because of the high output (mean+/-SD: 448.4+/-248.2 cc/24 h).


RESULTS
Ten of the 12 high-output fistulas healed in 27.8+/-27.7 days, whereas all low-output fistulas healed in 12.1+/-6.6 days.


CONCLUSIONS
Octreotide appears useful in the treatment of external pancreatic fistulas. For optimal results to be achieved, there must be no local infection and no mechanical or anatomical obstacles to the free flow of juice.
Bassi
C
C
Surgical and Gastroenterological Department, University of Verona, Policlinico "G.B. Rossi", I-37134 Verona, Italy. Bifo@Borgoroma.Univr.it
Falconi
M
M
Salvia
R
R
Caldiron
E
E
Butturini
G
G
Pederzoli
P
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006728:Hormones / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000627:therapeutic use*; D010185:Pancreatic Fistula / Q000188:drug therapy* / Q000209:etiology / Q000382:microbiology; D010189:Pancreatic Juice / Q000378:metabolism; D011446:Prospective Studies; D013530:Surgical Wound Infection / Q000188:drug therapy; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects
D006728:Hormones; D015282:Octreotide