Somatostatin analogues in the prevention of pancreas-related complications after pancreatic resection

Antonio Ramos-De la Medina, Michael G. Sarr

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Background/Purpose. The Achilles' heel of operative pancreatectomies is the pancreaticoenterostomy for proximal resections and the pancreatic parenchymal closure for distal resections. Inhibition of pancreatic exocrine secretions by somatostatin analogues has been suggested to decrease pancreas-specific complications, but this topic remains controversial. Methods. We performed a randomized, prospective, placebo-controlled, multicenter trial of the use of perioperative vapreotide, a potent somatostatin analogue, in pancreatic resections for presumed neoplasms in 381 patients without chronic pancreatitis. We also reviewed the literature on the use of somatostatin and its analogues after pancreatectomy. Results. When compared to the placebo, perioperative vapreotide had no effect on overall pancreas-specific complications (30.4% vs 26.4%), mortality (0% vs 1.4%), overall complications (40% vs 42%), and duration of hospitalization; there were no differences in complications per type of resection with use of vapreotide - proximal versus distal resection. Seven other prospective, randomized trials provide differing results. Conclusions: Our study with vapreotide failed to show any benefit when administered perioperatively (and for 7 days postoperatively) on pancreas-specific complications after major pancreatectomy in patients without chronic pancreatitis. The use of perioperative analogues that suppress pancreatic exocrine secretion seems not to be warranted as routine treatment.

Original languageEnglish (US)
Pages (from-to)190-193
Number of pages4
JournalJournal of Hepato-Biliary-Pancreatic Surgery
Volume13
Issue number3
DOIs
StatePublished - May 2006

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Somatostatin
Pancreatectomy
Pancreas
Chronic Pancreatitis
Placebos
Multicenter Studies
Hospitalization
Mortality
vapreotide
Neoplasms
Therapeutics

Keywords

  • Octreotide
  • Pancreatectomy
  • Pancreatic fistula
  • Pancreatic resection
  • Pancreaticoduodenectomy
  • Somatostatin
  • Vapreotide

ASJC Scopus subject areas

  • Surgery

Cite this

Somatostatin analogues in the prevention of pancreas-related complications after pancreatic resection. / Ramos-De la Medina, Antonio; Sarr, Michael G.

In: Journal of Hepato-Biliary-Pancreatic Surgery, Vol. 13, No. 3, 05.2006, p. 190-193.

Research output: Contribution to journalArticle

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