Clinical evaluation of somatostatin use in pancreatic resections: Clinical efficacy or limited benefit?

Perioperative albumin ratio is associated with post‐operative pancreatic fistula

“…[3][4][5][6] Besides these evidences, many efforts have been made to reduce incidence of POPF: modifications of surgical procedures, use of stent for internal or external drainage of pancreatic juice, prophylactic administration of somatostatin, management of abdominal drains. [10][11][12][13] Nevertheless, the role of some prognostic parameters is still controversial because not objective and lacking quantitative values; pancreas consistency is commonly considered a prognostic factor, confirmed in the present study ( Table 2), but texture is generally subjective and dependent of surgeon's experience. Recent studies suggested the opportunity to assess histologically the grade of pancreatic fibrosis in order to define objective and reproducible parameters able to define the role of pancreas consistency in POPF risk.…”

“…[3][4][5][6] Besides these well-studied parameters, the role of metabolism and nutritional status are still unclear and controversial in pancreatic surgery, even if they are demonstrated to be crucial in some pathological conditions. [10][11][12][13] The aim of this study was to assess simple, low-cost and objective predictors of POPF, comparing perioperative albumin levels with other clinico-pathologic and operative parameters. [10][11][12][13] The aim of this study was to assess simple, low-cost and objective predictors of POPF, comparing perioperative albumin levels with other clinico-pathologic and operative parameters.…”

“…[7][8][9] Furthermore, efforts to reduce the incidence of POPF have leaded to various modifications of the anastomotic techniques, pancreaticogastrostomy or pancreaticojejunostomy, the use of a stent, internal or external drainage, application of topical agents to the anastomotic site, prolonged peripancreatic surgical drainage, delayed oral intake and prophylactic administration of somatostatin. [10][11][12][13] The aim of this study was to assess simple, low-cost and objective predictors of POPF, comparing perioperative albumin levels with other clinico-pathologic and operative parameters.…”

Prophylactic octreotide for pancreatoduodenectomy: more harm than good?

“…The final major limitation of the studies that support octreotide use, and also many of the recent retrospective studies, is the absence of a comprehensive risk adjustment process. Most of the early literature was largely limited to univariate analyses, and even recent retrospective works have excluded highly validated risk factors, such as soft gland and duct size, when conducting multivariable testing .…”

“…Early biochemical investigation focused on somatostatin's ability to ameliorate pancreatitis through the inhibition of exocrine function; in spite of inconclusive findings, other studies suggested a benefit for reducing the incidence of post‐operative complications . Octreotide is a potent inhibitor of pancreatic exocrine secretion, and as pancreatic enzyme secretion is proposed as a driver of fistulae, some advocate its use as a prophylactic measure …”