[Evaluation of somatostatin or octreotide efficacy in the treatment of external pancreatic fistulas].
OBJECTIVE
To evaluate the prevalence of pancreatic pseudocyst after persistent fistula closure with somatostatin or octreotide. To compare the patient characteristics according to the subsequent presence or absence of pseudocyst.


METHODS
This retrospective study from January 1994 to August 1999 included 15 patients with an external pancreatic fistula. Fistula closure was observed for all patients with somatostatin or octreotide. CT scan was performed 66 +/- 34 days after the end of this treatment.


RESULTS
CT scan was normal in 9 patients (favorable group) and showed pancreatic pseudocyst (failure group) in 6 patients. Pancreatic fistula etiologies were different between the two groups. The 5 patients presenting pancreatic fistula after duodenopancreatectomy belonged to the favorable group. Six of the 10 patients presenting pancreatic fistula after pseudocyst drainage belonged to the failure group. There were no other differences between the two groups.


CONCLUSIONS
Persistent pancreatic fistula can be cured with somatostatin or octreotide. However, fistulas occurring after duodenopancreatectomy are more easily cured with somatostatin or octreotide than fistulas occurring after external pseudocyst drainage. Somatostatin or octreotide cannot be considered to be an effective treatment for pancreatic fistula occurring after pseudocyst drainage, despite the fact that 40% of them were permanently cured.
Service de chirurgie digestive et viscérale, CHU Nancy, Hôpital Brabois, 54511 Vandoeuvre, France. lbrunaud@planete.net
L
L
Brunaud
H
H
Sebbag
F
F
Marchal
A
A
Verdier
L
L
Bresler
J M
JM
Tortuyaux
P
P
Boissel
D017577:Cutaneous Fistula / Q000145:classification / Q000188:drug therapy* / Q000209:etiology; D004322:Drainage / Q000009:adverse effects; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000627:therapeutic use*; D010185:Pancreatic Fistula / Q000145:classification / Q000188:drug therapy* / Q000209:etiology; D010192:Pancreatic Pseudocyst / Q000139:chemically induced* / Q000000981:diagnostic imaging; D016577:Pancreaticoduodenectomy / Q000009:adverse effects; D015995:Prevalence; D012189:Retrospective Studies; D013004:Somatostatin / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D005765:Gastrointestinal Agents; D013004:Somatostatin; D015282:Octreotide