Octreotide Does Not Prevent Pancreatic Fistula Following Pancreatoduodenectomy in Patients with Soft Pancreas and Non-dilated Duct: A Prospective Randomized Controlled Trial

Kurumboor, Prakash; Palaniswami, Kamalesh Nadothottam; Pramil, Kaniyarakal; George, Deepak; Ponnambathayil, Shaji; Varma, Deepak; Aikot, Sylesh

doi:10.1007/s11605-015-2925-x

Cited by 53 publications

(44 citation statements)

References 26 publications

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“…Among the 12 identified studies, 6 were single-center trials conducted in the United States (1), [18] Belgium (1), [19] Switzerland (1), [20] Spain (1), [21] and India (2). [22,23] The other 6 studies were multicenter trials conducted in Germany (3), [24–26] Italy (1), [27] the United States (1), [28] and France (1). [29] The mean age ranged from 47.0 to 69.0 years.…”

Section: Resultsmentioning

confidence: 99%

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

Wang

Zhao²,

You³

2017

Medicine

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Section: Resultsmentioning

confidence: 99%

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

Wang

Zhao²,

You³

2017

Medicine

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“…Octreotide 100-200 μg subcutaneously 3-4 times/day for 6-8 days may reduce the risk for fistulation and minimize leakage after a difficult resection or enucleation of endocrine pancreatic Kaltsas et tumors, but may not be routinely required. However, recent prospective trials showed that such an approach had no effect [44,45] . If somatostatin has been used, it should be weaned slowly rather than discontinued abruptly.…”

Section: Pancreaticoduodenal Net: Pre-and Perioperative Therapymentioning

confidence: 99%

ENETS Consensus Guidelines for the Standards of Care in Neuroendocrine Tumors: Pre- and Perioperative Therapy in Patients with Neuroendocrine Tumors

et al. 2017

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Neuroendocrine tumors of the small intestine are the most common causes of the carcinoid syndrome. Carcinoid heart disease occurs in more than half of the patients with the carcinoid syndrome. Patients with carcinoid heart disease who need to undergo surgery should also undergo preoperative evaluation by an expert cardiologist. Treatment with long-acting somatostatin analogs aims at controlling the excessive hormonal output and symptoms related to the carcinoid syndrome and at preventing a carcinoid crisis during interventions. Patients with a gastrinoma require pre- and postoperative treatment with high doses of proton pump inhibitors. Patients with a glucagonoma require somatostatin analog treatment and nutritional supplementation. Patients with a VIPoma also require somatostatin analog treatment and intravenous fluid and electrolyte therapy. Insulinoma patients generally require intravenous glucose infusion prior to operation. In patients with localized operable insulinoma, somatostatin analog infusion should only be considered after the effect of this therapy has been electively studied.

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“…Although using the same definition of POPF, the amylase concentration could be much lower when placing the drainage tube apart from the pancreatic anastomotic stoma instead of placing it near the anastomotic stoma like we did in this study. Moreover, Kurumboor et al [23] reported a prospective randomized trial, with a high POPF rate of 63% in control group and 60% in octreotide treatment group. Severe POPF rate in their control group was a little lower than that in our placebo group (18.5% vs 24.0%); however, the rate in their octreotide treatment group was higher than that in our ulistatin group (10.9% vs 7.1%).…”

Section: Discussionmentioning

confidence: 99%

“…[24,25] However, more reports suggested that octreotide is not beneficial for POPF after pancreatic surgery. [18,23,26,27] Lowy et al [26] evaluated 110 patients undergoing PD and found that the rates of clinical pancreatic fistula and perioperative complications were 6% and 25% in the control group, and 12% and 30% in the octreotide group.…”

Section: Discussionmentioning

confidence: 99%

Preventive effects of ulinastatin on complications related to pancreaticoduodenectomy

Zhang¹,

Tan²,

Wang³

et al. 2016

Medicine

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Postoperative pancreatic fistula (POPF) is one of the most common major complications after pancreaticoduodenectomy (PD). Ulinastatin is an intrinsic trypsin inhibitor and mainly used to treat acute pancreatitis, chronic recurrent pancreatitis, and acute circulatory failure. The study aims to investigate the efficacy of ulinastatin on pancreatic fistula and other complications after PD. This prospective, randomized, double-blind, placebo-controlled trial was conducted in West China Hospital of Sichuan University from December 2012 to December 2014. A total of 106 consecutive patients undergoing PD were randomly assigned to receive ulinastatin or placebo during and after the surgery for 5 days. Baseline clinical characteristics and outcomes of patients were recorded and analyzed. Ninety-two patients including 42 in the ulinastatin group and 50 in the placebo group were available for outcome assessment. The POPF rates were comparable between ulinastatin group (43%) and placebo group (26%), whereas the severe pancreatic fistula rate (grade B + C) was significantly less in ulinastatin group than that in placebo group (7% vs 24%, P = 0.045). For patients with small pancreatic duct diameter (≤3 mm), ulinastatin could significantly reduce the risk of POPF (P = 0.022). Ulinastatin had protective effects for patients undergoing PD on the prevention of severe postoperative pancreatic fistula.

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Octreotide Does Not Prevent Pancreatic Fistula Following Pancreatoduodenectomy in Patients with Soft Pancreas and Non-dilated Duct: A Prospective Randomized Controlled Trial

Abstract: This study demonstrated no statistical difference in pancreatic fistulae with the use of octreotide, though there was a trend towards fewer incidences of pancreatic fistulae, morbidity and shorter hospital stay. ClinicalTrials.gov Identifier: NCT01301222.

Cited by 53 publications

References 26 publications

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

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

ENETS Consensus Guidelines for the Standards of Care in Neuroendocrine Tumors: Pre- and Perioperative Therapy in Patients with Neuroendocrine Tumors

Preventive effects of ulinastatin on complications related to pancreaticoduodenectomy

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