Octreotide hardens the pancreas.
OBJECTIVE
Leakage from pancreaticojejunostomy and development of pancreatic fistulas are the major postoperative complications in patients undergoing duodenopancreatectomy. The risk of developing these complications is higher when surgery is performed on a soft pancreas. A recent report suggests that octreotide hardens the pancreas when given intraoperatively. The present study aims at verifying this observation by measuring tissue hardness of the pancreas by a commercially available durometer in pigs with and without octreotide pretreatment.


METHODS
Three groups of pigs were investigated: Group 1 (n=6) received no treatment; group 2 (n=6) was treated with 3x100 microg octreotide for 1 day; group 3 (n=6) for 5 days. Thereafter, animals were killed and the pancreas was harvested for performing measurements: Tissue hardness was assessed by a commercially available durometer, and a suture holding test was performed using a Newton dynamometer.


RESULTS
There was a significant increase in tissue hardness between untreated control animals [26.3+/-2.5 S.U. (shore units)] and animals with 1 day octreotide pretreatment (29.8+/-2.6 S.U.; p=0.04) as well as between the groups treated for 1 and 5 days (34.8+/-2.8 S.U.; p=0.01). Suture holding capacity was higher in animals treated for 5 days.


CONCLUSIONS
The present study agrees with a recent report suggesting that octreotide hardens the pancreas. Octreotide pretreatment may therefore be an advantage when performing surgery on a soft pancreas, i.e., in patients scheduled for duodenopancreatectomy for ampullary carcinomas or circumscript pancreatic tumors not associated with chronic pancreatitis.
Foitzik
T
T
Department of General, Vascular, Thoracic and Transplantation Surgery, University of Rostock, Schillingallee 35, 18057, D-18057 Rostock, Germany. thomas.foitzik@med.uni-rostock.de
Gock
M
M
Schramm
C
C
Prall
F
F
Klar
E
E
D000818:Animals; D001696:Biomechanical Phenomena; D005765:Gastrointestinal Agents / Q000494:pharmacology*; D007273:Injections, Intramuscular; D023421:Models, Animal; D015282:Octreotide / Q000494:pharmacology*; D010179:Pancreas / Q000187:drug effects*; D013552:Swine; D013718:Tensile Strength / Q000187:drug effects
D005765:Gastrointestinal Agents; D015282:Octreotide