Octreotide in the Prevention of Intra-abdominal Complications Following Elective Pancreatic Resection

Suc, B.; Msika, Simon; Piccinini, M.; Fourtanier, G; Hay, Jean‐Marie; Flamant, Y; Fingerhut, Abe; Fagniez, Pierre-Louis; Chipponi, J

doi:10.1001/archsurg.139.3.288

Cited by 137 publications

(122 citation statements)

References 30 publications

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“…Somatostatin and its synthetic analogues (e.g., octreotide) reduce splanchnic blood flow and the release of pancreatic exocrine secretion [162]. The rationale for its use is to reduce the risk of pancreatic anastomotic fistulas by decreasing the volume of pancreatic exocrine secretions.…”

Section: Somatostatin Analoguesmentioning

confidence: 99%

Guidelines for Perioperative Care for Pancreaticoduodenectomy: Enhanced Recovery After Surgery (ERAS^®) Society Recommendations

et al. 2012

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Section: Somatostatin Analoguesmentioning

confidence: 99%

Guidelines for Perioperative Care for Pancreaticoduodenectomy: Enhanced Recovery After Surgery (ERAS^®) Society Recommendations

et al. 2012

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“…T h e y s h o w e d t h a t t h e i n c i d e n c e o f pancreatic fistula was 18% in the patients received perioperative octreotide treatment and 37% in patients received placebo after pancreatic resection. Suc et al [22] also described the advantage of using octreotide after pancreaticoduodenectomy.…”

Section: T a B L E 4 I N C I D E N C E O F P A N C R E A T I C F I S mentioning

confidence: 99%

Risk factors associated with pancreatic fistula after distal pancreatectomy, which technique of pancreatic stump closure is more beneficial?

Ridolfini

Alfieri²,

Gourgiotis³

et al. 2007

WJG

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AIM:To identify risk factors related to pancreatic fistula in patients undergoing distal pancreatectomy (DP) and to determine the effectiveness of using a stapled and a sutured closed of pancreatic stump. METHODS:Sixty-four patients underwent DP during a 10-year period. Information regarding diagnosis, operative details, and perioperative morbidity or mortality was collected. Eight risk factors were examined. RESULTS:Indications for DP included primary pancreatic disease (n = 38, 59%) and non-pancreatic malignancy (n = 26, 41%). Postoperative mortality and morbidity rates were 1.5% and 37% respectively; one patient died due to sepsis and two patients required a reoperation due to postoperative bleeding. Pancreatic fistula was developed in 14 patients (22%); 4 of fistulas were classified as Grade A, 9 as Grade B and only 1 as Grade C. Incidence of pancreatic fistula rate was significantly associated with four risk factors: pathology, use of prophylactic octreotide therapy, concomitant splenectomy, and texture of pancreatic parenchyma. The role that technique (either stapler or suture) of pancreatic stump closure plays in the development of pancreatic leak remains unclear. CONCLUSION:The pancreatic fistula rate after DP is 22%. This is reduced for patients with non-pancreatic malignancy, fibrotic pancreatic tissue, postoperative prophylactic octreotide therapy and concomitant splenectomy.

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“…Similar results were reported from two multicentre studies from Italy [71, 72]with 218 and 252 patients, respectively, and from an institutional study with 75 patients from France [73](table 7). The latest published trial, also from France, randomised 230 patients who underwent pancreato-duodenectomy (n = 177) or distal pancreatectomy (n = 53) either to octreotide (n = 122) or placebo (n = 108) [74]. There was no significant difference in the frequency of intra-abdominal complications (22% in the octreotide group versus 32% in the placebo group, p = 0.08) nor in the rate of pancreatic fistula (17 versus 19%, respectively).…”

Section: Complications Of Pancreatic Fistulamentioning

confidence: 99%

Surgical Treatment of Pancreatic Fistula

Alexakis¹,

Sutton²,

Neoptolemos³

2004

Dig Surg

101

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Background: Pancreatic fistula remains a significant problem in pancreatic disease, trauma and surgery. Whilst improved diagnostic and treatment techniques, including endoscopic approaches, have resulted in considerably improved outcomes, surgical intervention remains an important aspect of treatment but has been relatively poorly documented. Aims: The aims were to review the recent world literature on the relative incidence of pancreatic fistula and the results of surgical treatment. Results: The pancreatic fistula rate following partial pancreato-duodenectomy was 421 (12.9%) in 3,268 patients in 13 large series; 80 (13.0%) in 671 patients after left pancreatectomy in 6 large series, and 28 (11.9%) in 243 patients after pancreatic trauma in 4 recent series. The success rate of surgical procedures for external pancreatic fistulae was 101 (90.2%) in 112 patients with an overall mortality of 7 (6.3%) reported in 9 series. For internal pancreatic fistulae the success rate of surgical treatment was 61 (92%) in 66 patients with an overall mortality of 6 (9%) reported in 7 series. Conclusions: The treatment of established pancreatic fistula remains challenging. Although surgical treatment is reserved for patients who have failed all other treatments, the success rate is 90–92% but with a mortality of 6–9%.

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Octreotide in the Prevention of Intra-abdominal Complications Following Elective Pancreatic Resection

Cited by 137 publications

References 30 publications

Guidelines for Perioperative Care for Pancreaticoduodenectomy: Enhanced Recovery After Surgery (ERAS^®) Society Recommendations

Guidelines for Perioperative Care for Pancreaticoduodenectomy: Enhanced Recovery After Surgery (ERAS^®) Society Recommendations

Risk factors associated with pancreatic fistula after distal pancreatectomy, which technique of pancreatic stump closure is more beneficial?

Surgical Treatment of Pancreatic Fistula

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Octreotide in the Prevention of Intra-abdominal Complications Following Elective Pancreatic Resection

Cited by 137 publications

References 30 publications

Guidelines for Perioperative Care for Pancreaticoduodenectomy: Enhanced Recovery After Surgery (ERAS®) Society Recommendations

Guidelines for Perioperative Care for Pancreaticoduodenectomy: Enhanced Recovery After Surgery (ERAS®) Society Recommendations

Risk factors associated with pancreatic fistula after distal pancreatectomy, which technique of pancreatic stump closure is more beneficial?

Surgical Treatment of Pancreatic Fistula

Contact Info

Product

Resources

About

Guidelines for Perioperative Care for Pancreaticoduodenectomy: Enhanced Recovery After Surgery (ERAS^®) Society Recommendations

Guidelines for Perioperative Care for Pancreaticoduodenectomy: Enhanced Recovery After Surgery (ERAS^®) Society Recommendations