[Use of lanreotide in the prevention of pancreatic fistula after cephalic duodeno-pancreatectomy. Preliminary study].
OBJECTIVE
Dehiscence of pancreatic anastomosis is the main complication after pancreatoduodenectomy. The efficacy of somatostatin analogue to prevent complications after pancreatic resections is at present well-established by several randomized trials. The aim of this preliminary prospective study was to assess the role of lanreotide (a long acting somatostatin analogue) in this field.


METHODS
Forty patients with pancreatic head tumour have been included in a prospective study. Criteria for pancreatic fistula were: high concentration of amylase in the drainage fluid (> 3 times that in the serum), or intra-abdominal fluid collection adjacent to the pancreatic anastomosis, or reoperation (or postmortem verification) showing an anastomotic dehiscence. The patients received 12 h before the operation 30 mg of lanreotide intramuscularly.


RESULTS
Of the 40 patients included prospectively, 34 underwent a pancreatic resection. Parenchyma of pancreatic remnant was crumbly in 28 cases. Six patients experienced a pancreatic fistula (17.6%) which healed in all cases.


CONCLUSIONS
This preliminary study shows clearly the feasibility of a long acting somatostatin analogue (lanreotide) to prevent pancreatic fistula after pancreatectomy. This agent appears simple to use and its efficacy needs obviously to be assessed by randomized trials.
Slim
K
K
Service de chirurgie générale et digestive, Hôtel-Dieu, Clermont-Ferrand, France.
Buc
E
E
Lescure
G
G
Chanudet
M
M
Pezet
D
D
Chipponi
J
J
D006801:Humans; D008875:Middle Aged; D010185:Pancreatic Fistula / Q000209:etiology* / Q000517:prevention & control*; D016577:Pancreaticoduodenectomy; D010456:Peptides, Cyclic / Q000627:therapeutic use*; D011446:Prospective Studies; D013004:Somatostatin / Q000031:analogs & derivatives* / Q000627:therapeutic use
D010456:Peptides, Cyclic; C060347:lanreotide; D013004:Somatostatin