Meta-analysis of the value of somatostatin and its analogues in reducing complications associated with pancreatic surgery.
BACKGROUND
The role of somatostatin and its analogues in reducing complications after pancreatic resection is controversial. This is a meta-analysis of the evidence of benefit.


METHODS
A literature search using Medline and ISI Proceedings with exploration of the references identified 22 studies. Of these, ten met the inclusion criteria for data extraction. Estimates of effectiveness were performed using fixed- and random-effects models. The effect was calculated as an odds ratio (OR) with 95 per cent confidence intervals (c.i.) using the Mantel-Haenszel method. Level of significance was set at P < 0.050.


RESULTS
Outcomes for 1918 patients were compared. Somatostatin and its analogues did not reduce the mortality rate after pancreatic surgery (OR 1.17 (0.70 to 1.94); P = 0.545) but did reduce both the total morbidity (OR 0.62 (0.46 to 0.85); P = 0.003) and pancreas-specific complications (OR 0.56 (0.39 to 0.81); P = 0.002). Somatostatin and its analogues reduced the rate of biochemical fistula (OR 0.45 (0.33 to 0.62); P < 0.001) but not the incidence of clinical anastomotic disruption (OR 0.80 (0.44 to 1.45); P = 0.459).


CONCLUSIONS
Somatostatin and its analogues reduce the incidence of complications after surgery.
Connor
S
S
Clinical and Surgical Sciences (Surgery), University of Edinburgh, Royal Infirmary, Edinburgh, UK.
Alexakis
N
N
Garden
O J
OJ
Leandros
E
E
Bramis
J
J
Wigmore
S J
SJ
D006801:Humans; D016017:Odds Ratio; D010182:Pancreatic Diseases / Q000601:surgery*; D011183:Postoperative Complications / Q000517:prevention & control*; D013004:Somatostatin / Q000031:analogs & derivatives*; D016896:Treatment Outcome
D013004:Somatostatin