Octreotide and Pancreatic Perfusion on the Outcome of Experimental Acute Pancreatitis

Abstract

Objective: Pancreatic ischemia plays an important role in the initiation and outcome of acute pancreatitis. Somatostatin, widely used for its treatment, is also given for gastrointestinal bleeding control, since it operates by decreasing the splanchnic blood flow. The present study was thus conducted in rats to evaluate the influence of the somatostatin analogue, octreotide, given as prophylaxis or treatment, on pancreatic tissue perfusion during recovery from experimental acute pancreatitis. Method: 32 rats were divided into 4 groups: sham operation plus octreotide (group O, n = 8), pancreatitis induction (group P, n = 8), pancreatitis induction plus octreotide (group P+O, n = 8), and octreotide prior to pancreatitis induction (group O+P, n = 8). Acute pancreatitis was induced by sodium taurocholate infusion in a closed duodenal loop and pancreatic tissue perfusion was assessed by means of the laser-Doppler technique at 0, 30, 60 min and 12 h after the initial measurement. Results: All animals exhibited an equal reduction in pancreatic tissue perfusion of about 45% the initial value at 30 min, having either been subjected to pancreatitis (groups P and P+O) or octreotide treatment only (groups·and O+P). At 60 min both groups O+P and P+O exhibited a further reduction (p < 0.001) to 31.61 ± 8.78 and 32.42 ± 5.44% the initial values, while groups·and P remained at 44.18 ± 2.77 and 44.12 ± 2.58% the initial values. At 12 h group·presented pancreatic perfusion equal to 33.37 ± 14.38% the initial value and group P a perfusion of 23.16 ± 3.78%, while groups O+P and P+O exhibited an extreme decline in pancreatic perfusion, the diminution being 11.08 ± 3.77 and 10.97 ± 1.79% the initial values, respectively (p < 0.0001). Conclusions: Octreotide, given either as prophylaxis or treatment, seems to aggravate the already decreased pancreatic perfusion due to the onset of pancreatitis.