In vivo Octreotide Administration Acutely Reduces Exocrine Granule Size in the Human Pancreas

Falconi, Massimo; Caldiron, E.; Zancanaro, Carlo; Benati, Donatella; Talamini, Giorgio; Bassi, Claudio; Pederzoli, Paolo

doi:10.1159/000055789

Cited by 8 publications

(3 citation statements)

References 34 publications

(30 reference statements)

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“…A recent study demonstrates an acute reduction of pancreatic granule size and number induced by a single dose of octreotide administration. This effect, however, was not sustained by prolonged administration of the drug [6].…”

Section: Introductionmentioning

confidence: 84%

Effects of Octreotide Pretreatment in Experimental Acute Pancreatitis

et al. 2003

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Section: Introductionmentioning

confidence: 84%

Effects of Octreotide Pretreatment in Experimental Acute Pancreatitis

et al. 2003

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“…Thin sections were doubly stained with uranyl acetate and lead nitrate, and examined under Philip EM 400 electron microscope. A systematic randomized protocol was used to select tissue areas for morphometric analysis [14] . In each grid, 10 pictures were taken by one operator at a magnification of 150 for a total of ten negatives per sample.…”

Section: Electron Microscopymentioning

confidence: 99%

Effect of parenteral and early intrajejunal nutrition on pancreatic digestive enzyme synthesis, storage and discharge in dog models of acute pancreatitis

Qin

Su²,

Hu³

et al. 2007

WJG

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Qin HL, Su ZD, Hu LG, Ding ZX, Lin QT. Effect of parenteral and early intrajejunal nutrition on pancreatic digestive enzyme synthesis, storage and discharge in dog models of acute pancreatitis. World J Gastroenterol 2007; 13(7): 1123-1128http://www.wjgnet.com/1007-9327/13/1123.asp INTRODUCTIONBeneficial effects of total enteral nutrition (TEN) have been noted in a number of diseases, such as burn, trauma, and sepsis. In comparison with parenteral nutrition (PN), TEN can reduce nosocomial infection, multiple organ failure (MOF), and the length of hospitalization [1][2][3][4] . Early enteral nutritional (EEN) support in patients with acute pancreatitis (AP) has been evaluated by some authors who reported that it can moderate the acute phase response and improve disease severity and clinical outcome [5][6][7][8][9][10] . However, the commonly encountered problems of gastric atony and outlet obstruction have limited the successful delivery of enteral nutrition to patients with severe acute pancreatitis. In addition, many surgeons believe that EEN may lead to recurrence of symptoms and delayed complications, because EEN may increase the release of digestive enzymes and lysosomal hydrolases. This action of digestive enzymes and lysosomal hydrolases may be important in the development of acute pancreatitis, as lysosomal enzymes such as cathepsin B, are known to be capable of activating trypsinogen and intracellular digestive enzymes that may trigger the autodigestive phenomenon of the pancreas [11] . However, these problems may be overcome if enteral nutrition is delivered to the jejunum as distal as possible from Treitz's ligament, thereby avoiding stimulation of the cephalic and gastric phase. Therefore, it is necessary to investigate the effect of early intrajejunal nutrition (EIN) on pancreatic acinar cell uptake of 3 H phenylalanine, digestive enzyme synthesis, storage and discharge in dogs with AP. MATERIALS AND METHODS Materials Abstract AIM:To study the effect of early intrajejunal nutrition on enzyme-protein synthesis and secretion during acute pancreatitis. METHODS:Fifteen dogs were randomly divided into parenteral nutrition (n = 7) and early intrajejunal nutrition groups (n = 8). An acute pancreatitis model was induced by injecting 5% sodium taurocholate and trypsin into the pancreas via the pancreatic duct. Intrajejunal nutrition was delivered with a catheter via a jejunostomy t u b e a f t e r t h e m o d e l wa s e s t a b l i s h e d fo r 2 4 h . On d 1 and 7 and at the beginning of nutritional support, radioactive tracing and electron microscopes were used to evaluate the enzyme-protein synthesis in acinar cells, the subcellular fractionation and the change in zymogen granules after 1.85 × 10 6 Bq L-3 H phenylalanine was infused at 30, 60, 120, and 180 min. RESULTS:The 3 H radioactivity in pancreatic acinar cells reached its peak level at 60 min, and the contents in the early intrajejunal nutrition group were higher than those in the parenteral nutrition group, which were then decreased. The mean numbe...

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“…Most proponents of octreotide use believe that it reduces fistula formation and promotes fistula closure in two different ways: it inhibits exocrine pancreatic secretion and it hardens the pancreatic tissue. While the first mechanism was scientifically proven in numerous studies (8, 11, 12), the theory about the hardening effect of octreotide on pancreatic texture is based on the results of a single animal experiment and a small case series in humans (13, 14). The first study reported a significant hardening effect after a single injection of octreotide in the gastroduodenal artery (GDA) in humans undergoing PD (13).…”

Section: Introductionmentioning

confidence: 99%

Effects of Intra-Arterial Octreotide on Pancreatic Texture: A Randomized Controlled Trial

et al. 2013

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Background and Aims:Octreotide is suggested to harden the pancreas, thus facilitating the construction of a pancreatic anastomosis and lowering the risk of postoperative fistula. We tested the hypothesis that intra-arterial application of octreotide in the gastroduodenal artery during pancreatectomy may increase pancreatic hardness.Material and Methods: A single-center, prospective, double-blinded, randomized controlled trial with parallel assignment was conducted. Patients planned for a pancreatoduodenectomy or a total pancreatectomy, who had a palpatory and durometer proven (<40 Shore units) soft pancreas, were assigned to receive intraoperatively either 5 mL 500µg octreotide or 5 mL 0.9% saline solution as a bolus injection in the gastroduodenal artery. Pancreatic hardness was measured before, early, and late after intervention. The investigator performing the durometer measurements and pathologist were masked to group assignment. The primary outcome was increased pancreatic hardness. Analysis was by intention to treat. This trial is registered at http://www.clinicaltrials.gov (ID NCT01400100).Results: A total of 12 patients received octreotide and 13 received saline solution. Pancreatic hardness marginally increased in the octreotide group: 0.67 ± 2.3 Shore units, whereas it decreased in the control group: −2.15 ± 2.7 Shore units. The difference was statistically significant, p = 0.029 (95% confidence interval = −4.87 to −0.77). Histology did not find any correlate for this clinically irrelevant hardening effect.Conclusions: A single bolus application of octreotide did not deliver a clinically relevant increase in pancreatic hardness. Future studies on the hardening effect of octreotide should employ repeated or continuous preoperative administration of this drug.

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In vivo Octreotide Administration Acutely Reduces Exocrine Granule Size in the Human Pancreas

Cited by 8 publications

References 34 publications

Effects of Octreotide Pretreatment in Experimental Acute Pancreatitis

Effects of Octreotide Pretreatment in Experimental Acute Pancreatitis

Effect of parenteral and early intrajejunal nutrition on pancreatic digestive enzyme synthesis, storage and discharge in dog models of acute pancreatitis

Effects of Intra-Arterial Octreotide on Pancreatic Texture: A Randomized Controlled Trial

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