title: Octreotide prophylaxis is not beneficial for biochemical activity and clinical severity of postoperative pancreatic fistula after pancreatic surgery.
abstract: BACKGROUND
  Prospective randomized trials indicate that prophylactic octreotide treatment does not decrease the incidence of postoperative pancreatic fistula (POPF). The aim of this study was to analyze if octreotide prophylaxis could decrease the severity grade of POPFs after pancreatic surgery.
  
  
  METHODS
  Seventy-eight of 684 patients undergoing pancreatic resection with POPF were included in the study. Prophylactic octreotide treatment was started immediately after surgery and was performed in 22 patients, whereas 56 patients had no octreotide treatment and served as controls. Lipase activity was measured in the abdominal drainage on postoperative days (POD) 3, 5 and 7. Primary endpoints of the study were clinical severity of the POPF and lipase activity in the drainage.
  
  
  RESULTS
  There was no significant difference concerning length of postoperative hospital stay. Lipase activity in the abdominal drainage was not influenced by octreotide prophylaxis at POD 5 or 7 compared to POD 3. Multivariate analysis showed that the risk to develop a type B or C fistula in the octreotide group was independent of the kind of operation and the consistency of the pancreas (RR = 3.4; CI = 1.0-11.7; p = 0.050 and RR = 6.3; CI = 1.4-29.6; p = 0.019).
  
  
  CONCLUSIONS
  Octreotide prophylaxis after pancreatic surgery has no beneficial effect on clinical severity of POPF.
authors: Department of General, Visceral, Vascular and Pediatric Surgery, University of Saarland, Homburg, Germany. velthuissimone@gmail.com
authors: R A
authors: RA
authors: Droeser
authors: P
authors: P
authors: Jeanmonod
authors: J
authors: J
authors: Schuld
authors: M R
authors: MR
authors: Moussavian
authors: M K
authors: MK
authors: Schilling
authors: O
authors: O
authors: Kollmar
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D004334:Drug Administration Schedule; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006801:Humans; D053208:Kaplan-Meier Estimate; D007902:Length of Stay / Q000706:statistics & numerical data; D008049:Lipase / Q000378:metabolism; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015282:Octreotide / Q000627:therapeutic use*; D010180:Pancreatectomy; D010185:Pancreatic Fistula / Q000209:etiology / Q000378:metabolism / Q000517:prevention & control*; D016577:Pancreaticoduodenectomy; D011182:Postoperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology / Q000378:metabolism / Q000517:prevention & control*; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D005765:Gastrointestinal Agents; D008049:Lipase; D015282:Octreotide