title: Perioperative application of somatostatin analogs for pancreatic surgery-current status in Germany.
abstract: BACKGROUND
  The most common major complication after pancreatic resection is the postoperative pancreatic fistula (POPF). Somatostatin analogs can reduce POPF, but the use of somatostatin analogs is still controversial. The aim of this study was to assess treatment algorithms for pancreatic surgery in Germany with a special focus on the application of somatostatin analogs.
  
  
  METHODS
  A questionnaire evaluating the perioperative management-especially the use of somatostatin analogs-and postoperative complications after pancreatic surgery was developed and sent to 209 German hospitals performing >12 pancreatoduodenectomies per year (the requirement for certification as a pancreas center). Statistical analysis was carried out using SPSS 21.
  
  
  RESULTS
  The final response rate was 77 % (160/209), 14.5 % of hospitals never, 37 % always, and 45 % occasionally apply somatostatin analogs after pancreatic surgery. A (standard) drug of choice was defined in 64 % of hospitals. When standard and occasional usage was analyzed, it appeared that hospitals favored somatostatin (69 %) > sandostatin (50 %) > pasireotide (5 %). A relation between the usage of the different somatostatin analogs and morbidity (POPF) or mortality (84 and 16 % of hospitals reported <5 and 5-10 %, respectively) was not seen. Eighty-seven percent of hospitals were interested in participating in future studies analyzing somatostatin use.
  
  
  CONCLUSIONS
  This is the first national survey in Germany evaluating the perioperative application of somatostatin analogs for pancreatic surgery. Despite controversial results in the literature, the majority of German pancreas surgeons apply somatostatin analogs perioperatively. The ideal drug to reduce POPF is still unclear. This uncertainty has aroused significant interest and prompted surgeons to participate in future studies in order to elucidate this issue.
authors.affiliation: Department of Visceral, Thoracic and Vascular Surgery, University Hospital, Fetscherstraße 74, 01307, Dresden, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Volk
authors.affiliation: Department of Visceral, Thoracic and Vascular Surgery, University Hospital, Fetscherstraße 74, 01307, Dresden, Germany.
authors.forename: Philipp
authors.initials: P
authors.lastname: Nitschke
authors.affiliation: Department of Visceral, Thoracic and Vascular Surgery, University Hospital, Fetscherstraße 74, 01307, Dresden, Germany.
authors.forename: Franziska
authors.initials: F
authors.lastname: Johnscher
authors.affiliation: Department of Visceral, Thoracic and Vascular Surgery, University Hospital, Fetscherstraße 74, 01307, Dresden, Germany.
authors.forename: Nuh
authors.initials: N
authors.lastname: Rahbari
authors.affiliation: Department of Visceral, Thoracic and Vascular Surgery, University Hospital, Fetscherstraße 74, 01307, Dresden, Germany.
authors.forename: Thilo
authors.initials: T
authors.lastname: Welsch
authors.affiliation: Department of Visceral, Thoracic and Vascular Surgery, University Hospital, Fetscherstraße 74, 01307, Dresden, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Reißfelder
authors.affiliation: Department of Visceral, Thoracic and Vascular Surgery, University Hospital, Fetscherstraße 74, 01307, Dresden, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Weitz
authors.affiliation: Department of Visceral, Thoracic and Vascular Surgery, University Hospital, Fetscherstraße 74, 01307, Dresden, Germany.
authors.forename: Marius
authors.initials: M
authors.lastname: Distler
authors.affiliation: Department of Visceral, Thoracic and Vascular Surgery, University Hospital, Fetscherstraße 74, 01307, Dresden, Germany. soeren.mees@uniklinikum-dresden.de.
authors.forename: Soeren Torge
authors.identifier: http://orcid.org/0000-0002-3876-3535
authors.initials: ST
authors.lastname: Mees
mesh_terms: D000465:Algorithms; D005858:Germany; D006728:Hormones / Q000627:therapeutic use*; D006801:Humans; D010180:Pancreatectomy / Q000009:adverse effects*; D010185:Pancreatic Fistula / Q000209:etiology / Q000517:prevention & control*; D010190:Pancreatic Neoplasms / Q000601:surgery; D016577:Pancreaticoduodenectomy / Q000009:adverse effects; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*; D010818:Practice Patterns, Physicians'; D013004:Somatostatin / Q000031:analogs & derivatives* / Q000627:therapeutic use*
chemical_list: D006728:Hormones; D013004:Somatostatin
keywords: Pancreas surgery; Pasireotide; Postoperative pancreatic fistula; Somatostatin