Effect of Somatostatin on Bile-Induced Acute Hemorrhagic Pancreatitis in the Dog

Schwedes, U.; Ph, Althoff; Klempa, I; Leuschner, U.; Mothes, L; Raptis, Sotirios A.; Wdowinski, J. M.; Kh, Usadel

doi:10.1055/s-0028-1092793

Cited by 64 publications

(18 citation statements)

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“…[38]; (4) the reduction of splanchnic blood flow, since changes in microcirculation or hemodynamic properties can lead to possible cyto-and organoprotective as well as stimulatory effect of somatostatin and its analogue on the RES further deterioration in the disease [21][22][23]. However, other authors found octreotide to protect against postis- [28][29][30][31][32][33][34][35][36][37][38][39][40][41], and (5) the continuation of pancreatic enzyme synthesis after the induction of the disease [35]. chemic reperfusion injuries [24].…”

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confidence: 99%

The Role of Octreotide and Somatostatin in Acute and Chronic Pancreatitis

et al. 1999

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Acute pancreatitis may follow a mild or a severe course. Whereas mild or edematous pancreatitis is a self-limiting disease with a low complication rate and low death rate, morbidity and mortality in severe or necrotizing pancreatitis are still unacceptably high. The major problem is the lack of a specific drug, especially in the early phase of the disease, to interfere with the systemic inflammatory response syndrome and to limit or prevent complications of the disease. Although the initiating pathophysiological process is not known, the destruction of the gland (‘autodigestion’) by digestive enzymes may be responsible for disease progression. Inhibition of pancreatic activity, which reduces exocrine secretion and further prevents the release and activation of enzymes, was therefore suggested as a specific treatment concept. The results of clinical investigations using somatostatin or its analogue are controversial, since all these trials had low statistical power. In a recent multicenter randomized controlled study with a large number of patients (n = 302) (and an adequate level of disease severity), no benefit of octreotide on progression or outcome was found. Chronic pancreatitis is characterized by an irreversible destruction of the exocrine and endocrine pancreatic parenchyma leading to maldigestion and diabetes. Pain, which may be caused by increased ductal pressure, is one of the most dominant symptoms in chronic pancreatitis. However, no beneficial effects on pain with pancreatic exocrine secretion-inhibiting drugs have been demonstrated. Treatment of other complications of the disease (pseudocyst formation, fistula and pancreatic ascites), with somatostatin or octreotide has given conflicting results. However, in a prophylactic clinical setting (e.g. elective pancreatic surgery) the inhibition of exocrine pancreatic secretion reduces complications.

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confidence: 99%

The Role of Octreotide and Somatostatin in Acute and Chronic Pancreatitis

et al. 1999

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“…Previous experimental data have shown that somatostatin could be used in acute pancreatitis, as it decreases the pancreatic damage and normalizes the blood enzyme levels [5,12,18]. One study was unable to show any influence of somatostatin on the development of the disease or the enzyme levels [ 13].…”

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confidence: 85%

“…Some report that so matostatin is beneficial whilst others show no effect of the drug [5,12,13,18]. No con trolled clinical studies have been performed using somatostatin in acute pancreatitis.…”

Section: Introductionmentioning

confidence: 99%

Microcirculatory Effects of Somatostatin in Acute Pancreatitis

Schröder¹,

Millard

Nakajima

et al. 1988

Eur Surg Res

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Somatostatin, a 28-amino-acid inhibitory polypeptide has been advocated for the treatment of upper gastrointestinal bleeding and acute pancreatitis. This study examines the effect of somatostatin in acute hemorrhagic pancreatitis in piglets (n = 12), weighing 8–12 kg. Six animals served as controls, and received only fluid resuscitation (0.9%, NaCl, 20 ml/kg/h). Six animals received somatostatin treatment consisting of a 15 µg/kg bolus i.v. given simultaneously with the induction of pancreatitis, and treatment continued with an intravenous infusion (15 µg/kg/h) for 5 h. Cardiac output, heart rate, blood pressure, arterial pO₂ hematocrit and serum amylase were recorded before and each hour during the experiment. Regional blood flow in the gastrointestinal area was measured using the microsphere method. The microspheres labelled with three different isotopes were administered before the experiment and at 2 and 5 h, respectively. There was a significant decrease in the cardiac output (p < 0.05) and an increase in systemic blood pressure in the somatostatin-treated group (p < 0.025). Pancreatic blood flow decreased by 43 % following somatostatin infusion. The decreases at 2 and 5 h were highly significant (p < 0.005). Blood flow to the mucosal but not muscular region of the stomach was decreased by somatostatin. This study suggests that somatostatin might be harmful in acute pancreatitis due to its adverse effects on pancreatic blood flow and cardiac output. However, somatostatin may be effective in reducing gastrointestinal bleeding. If the drug is used clinically, careful monitoring of the cardiac output is necessary.

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“…Schwedes et al 26 induced acute pancreatitis in dogs and found considerable less inflammatory damage to the pancreas in animals treated with somatostatin. The "cytoprotective" effect of somatostatin was assumed to be the cause.…”

Section: Discussionmentioning

confidence: 99%

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

Khurram¹,

Bhar²,

Bhattacharya³

et al. 2016

jemds

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BACKGROUNDAcute pancreatitis is the final result of premature pancreatic pro-enzyme activation leading to "auto digestion" of the parenchyma, thereby inducing a cascade of inflammatory response which further damages the organ. Theoretically inhibition of pancreatic secretion may prove useful in management of acute pancreatitis. There are evidences that somatostatin and octreotide apart from having inhibitory effect on pancreatic secretion also has some cytoprotective properties and that they counter the ileus and bacterial translocation in acute pancreatitis.

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Effect of Somatostatin on Bile-Induced Acute Hemorrhagic Pancreatitis in the Dog

Cited by 64 publications

References 1 publication

The Role of Octreotide and Somatostatin in Acute and Chronic Pancreatitis

The Role of Octreotide and Somatostatin in Acute and Chronic Pancreatitis

Microcirculatory Effects of Somatostatin in Acute Pancreatitis

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

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