Efficacy of the prophylactic use of octreotide for the prevention of complications after pancreatic resection

Wang, Chunli; Zhao, Xin; You, Sylvaine

doi:10.1097/md.0000000000007500

Cited by 15 publications

(10 citation statements)

References 44 publications

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“…Our study also demonstrated similar reduction in hospitalization days. In agreement with the previous trials reviewed by Li et al the incidence of complications associated with AP was found to be lesser in the somatostatin group compared with the octreotide group and the somatostatin + octreotide group [ 9 ], The proportion of organ failure was low in the octreotide group, which is in accordance with previous trials conducted for the octreotide group, than in control [ 23 ]. As somatostatin analogs are pancreatic enzyme inhibitors [ 24 ], the recovery time for serum AMY/LPS was shorter in somatostatin-treated patients than that in the octreotide-treated patients, suggesting rapid recovery of AP patients treated with somatostatin.…”

Section: Discussionsupporting

confidence: 91%

Current diagnosis and treatment of acute pancreatitis in China: a real-world, multicenter study

et al. 2021

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Background Efficacy of pancreatic enzyme inhibitors in acute pancreatitis (AP) is unclear in China. Aims We aimed to present the current status of AP and evaluate the efficacy of pancreatic enzyme inhibitors in a larger population in China. Method A retrospective, cross-sectional, real-world, multicenter analysis of a large dataset of patients presenting with AP from four hospitals of China over a two-year period was performed. Data were collected from the existing clinical records and the patients were grouped into medication group (somatostatin or octreotide or somatostatin and octreotide) and no medication group. Pair wise propensity score matching was performed for comparing somatostatin, octreotide and somatostatin/octreotide. The end points were incidence of disease complications, organ failure, hospitalization duration, and recovery time taken (hours) for serum amylase/serum lipase to normalcy. Results A total of 3900 patients were recruited and 2775 patients were included for analysis. A total of 1100, 661, 676 and 338 patients received either somatostatin or octreotide or somatostatin and octreotide or no medication, respectively. The incidence of complications (7.6% vs 13.6%), organ failure (4.5% vs 7.4%), and the instances of entering ICU (9.3% vs 13.3%) were higher in unmedicated group. Complications at discharge (2.91 times), organ failure (2.53 times), and hospitalization stay were higher in octreotide-treated patients compared with somatostatin-treated patients. In comparison to the octreotide group, the serum amylase/lipase recovery time was shorter in the somatostatin group. Conclusion This real-world study suggested that the use of pancreatic enzyme inhibitors was positively associated with greater clinical efficacy in AP patients and somatostatin might be more effective than octreotide in real-world settings in China.

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Section: Discussionsupporting

confidence: 91%

Current diagnosis and treatment of acute pancreatitis in China: a real-world, multicenter study

et al. 2021

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“…The present evidence suggests that prophylactic octreotide had no effective role in reducing the incidence of complications after pancreatic surgery, including the incidence of PF. The results were different from those of previous meta-analyses [35–37] that showed that the prophylactic use of octreotide could significantly reduce the incidence of some complications, especially PF. Some previous studies recommended the prophylactic use of octreotide.…”

Section: Discussioncontrasting

confidence: 99%

An updated systematic review and meta-analysis of the use of octreotide for the prevention of postoperative complications after pancreatic resection

et al. 2019

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Background:The use of octreotide prophylaxis following pancreatic surgery is controversial. We aimed to evaluate the effectiveness of octreotide for the prevention of postoperative complications after pancreatic surgery through this systematic review and meta-analysis.Methods:Literature databases (including the MEDLINE, EMBASE, and Cochrane databases) were searched systematically for relevant articles. Only randomized controlled trials (RCTs) were eligible for inclusion in our research. We extracted the basic information regarding the patients, intervention procedures, and all complications after pancreatic surgery and then performed the meta-analysis.Results:Thirteen RCTs involving 2006 patients were identified. There were no differences between the octreotide group and the placebo group with regard to pancreatic fistulas (PFs) (relative risk [RR] = 0.79, 95% confidence interval [CI] = 0.62–0.99, P = .05), clinically significant PFs (RR = 1.01, 95% CI = 0.68–1.50, P = .95), mortality (RR = 1.21, 95% CI = 0.78–1.88, P = .40), biliary leakage (RR 0.84, 95% CI = 0.39–1.82, P = .66), delayed gastric emptying (RR = 0.83, 95% CI = 0.54–1.27, P = .39), abdominal infection (RR = 1.00, 95% CI = 0.66–1.52, P = 1.00), bleeding (RR = 1.16, 95% CI = 0.78–1.72, P = .46), pulmonary complications (RR = 0.73, 95% CI = 0.45–1.18, P = .20), overall complications (RR = 0.80, 95% CI = 0.64–1.01, P = .06), and reoperation rates (RR = 1.18, 95% CI = 0.77–1.81, P = .45). In the high-risk group, octreotide was no more effective at reducing PF formation than placebo (RR = 0.81, 95% CI = 0.67–1.00, P = .05). In addition, octreotide had no influence on the incidence of PF (RR = 0.38, 95% CI = 0.14–1.05, P = .06) after distal pancreatic resection and local pancreatic resection.Conclusion:The present best evidence suggests that prophylactic use of octreotide has no effect on reducing complications after pancreatic resection.

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“…In addition, before the procedure we usually use octreotide to inhibit pancreatic exocrine activity. This has been shown to reduce the incidence of pancreatitis after pancreas biopsy …”

Section: Discussionmentioning

confidence: 99%

1.0T MR‐guided percutaneous coaxial cutting needle biopsy in pancreatic lesion diagnosis

Liu

Wang

et al. 2018

Magnetic Resonance Imaging

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Efficacy of the prophylactic use of octreotide for the prevention of complications after pancreatic resection

Abstract: Supplemental Digital Content is available in the text

Cited by 15 publications

References 44 publications

Current diagnosis and treatment of acute pancreatitis in China: a real-world, multicenter study

Current diagnosis and treatment of acute pancreatitis in China: a real-world, multicenter study

An updated systematic review and meta-analysis of the use of octreotide for the prevention of postoperative complications after pancreatic resection

1.0T MR‐guided percutaneous coaxial cutting needle biopsy in pancreatic lesion diagnosis

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