Continuous Intravenous Octreotide Treatment for Acute Experimental Pancreatitis

Abstract

Background: The efficacy of octreotide, the synthetic analogue of the hormone somatostatin, for the treatment of acute pancreatitis is controversial. Octreotide has been commonly administered in subcutaneous bolus injections; however, continuous intravenous infusion may be advantageous for acute conditions. Methods: Acute experimental pancreatitis was induced in rats by intraparenchymal injections of 1 ml 10% sodium taurocholate, and octreotide (1 µg/kg/h, dissolved in physiological solution, intravenously was started 4 h later and continuously infused for 48 h. Physiological solution infusions, in identical volumes, were used in the controls. The following parameters were examined: mortality; macroscopic and histological damage; hematocrit; plasma pH; acid-base balance; serum glucose; calcium, and amylase. Results: Octreotide treatment had a striking effect on mortality: 8.3 versus 91.6% in the treatment and control groups, respectively (p < 0.001). Octreotide also ameliorated pancreatic edema and intestinal dilatation, and had significant beneficial effects on histopathological damage and the biochemical alterations which are associated with acute pancreatitis. Conclusions: Continuous intravenous octreotide infusion is a potentially efficacious therapeutic method for acute pancreatitis.

Effect of Octreotide on Acute Pancreatitis Patients in Kolkata, India: A Randomized Controlled Trial

“…Upon the theory that inhibition of pancreatic secretion may be beneficial in acute pancreatitis, researches began in early 1980s with conflicting reports. 10,11,[14][15][16][21][22][23] Choi et al 10 saw a "beneficial local effect" and remarked that "local inflammation was supressed by somatostatin treatment." Even when better clinical outcomes were seen, the results failed to prove a statistical significance.…”

Acute pancreatitis, bacterial translocation, and different octreotide regimens: An experimental study

“…23 Paran et al, Kaplan et al, and Greenberg et al reported that OA has positive effects in some pancreatitis models in rats, biochemically and histopathologically. [24][25][26] Despite these studies, Sanchez Manuel et al reported that OA does not have a positive effect, either histopathologically or biochemically, in pancreatitis. 27 It has been reported that free oxygen radicals play an important role in the pathogenesis of acute pancreatitis.…”

Effects of octreotide in acute hemorrhagic necrotizing pancreatitis in rats

“…The effect of octreotide on pancreatitis has been investigated in several experimental and clinical trials 2–12 . However, the results are inconsistent as different models of pancreatitis were used and the optimal treatment modality, dosage and route of administration have not been delineated.…”

“…Although decreasing effects of octreotide on pancreatic autodigestion were observed in several trials [2][3][4][5][6][7][8][9][10][11][12][13] results remain inconclusive concerning doses and time of application in AP. In terms of the mechanism of octreotide it has been demonstrated that somatostatin and related analogs (octreotide) decrease lipid peroxidation in septic rats 14 by inhibition of activated neutrophils and monocytes, 15,16 which normally increase oxygen radicals and lipid peroxidation.…”