Role of Somatostatin and Octreotide in the Treatment of Pancreatic Pseudocyst, Fistula and Ascites

Abstract

Somatostatin and its analogue (SMS 201-995, octreotide) have proven to effectively inhibit various gastrointestinal functions including exocrine and neuroendocrine secretion, motility and splanchnic blood flow. The long half-life and the ability to administer the analogue subcutaneously has liberalized its use in different intestinal and extraintestinal disorders. In particular, the profound inhibitory effects on exocrine pancreatic function have prompted the use of SMS in several pancreatic disorders. Despite the lack of controlled studies, somatostatin has been used in different pancreatic disorders, fistulas, pseudocysts and ascites. The preliminary evidence supports a definite role of this analogue as adjunctive and primary therapeutic agents.

Endoscopic treatment as first‐line therapy for pancreatic ascites and pleural effusion

“…18 In view of these facts it is clear that endoscopic therapy should be considered the first line of treatment for patients with pancreatic ascites or pleural effusion. Early reports on drugs suppressing pancreatic secretion such as Somatostatin and Octreotide suggested that these are useful in the management of PA. 19,20 In a study by Segal et al, ascites disappeared in 9 out of the 10 patients over a period of 22 (Ϯ3) days. 19 However other studies combining nil-per-oral, total parenteral nutrition, somatostatin or its analogue and serial paracentesis have reported much lower success rates of 25-60%.…”

“…Early reports on drugs suppressing pancreatic secretion such as Somatostatin and Octreotide suggested that these are useful in the management of PA 19,20 . In a study by Segal et al.…”

Role of Somatostatin and Its Analogues in Gastrointestinal Fistulas, Ascites and Pancreatic Pseudocysts

“…It is within the context of this latter characteristic and the related attempt to cure the condition that SMS has established a role for itself as adjuvant treatment aimed at curbing exocrine secretion and thus catheter output by pharmacological means [1], In the study conducted by Barkin et al [20], as in that reported by Morali et al [21], the combination of percutaneous treatment and SMS has been shown to be capable of producing definitive healing in 4 patients in the space of roughly 1 month. Attempts to treat the condition with the drug alone are reported in a number of pilot studies [22][23][24] in a total of only 9 patients.…”

“…The potent inhibitory capacity of somatostatin on both the exocrine and neuroendocrine secretion of the diges tive tract provides a convincing rationale for the use of the original molecule and its synthetic derivative, octreotide (SMS), for the treatment of all those conditions requiring inhibition of intestinal secretions [1], This inhibitory capacity can be used both in the course of diseases respon sible for hyperstimulation of secretion and in the course of newly formed anatomical situations which alter the physi ological outflow of the gastrointestinal tract. This latter condition is typical of external and internal intestinal fis tulas.…”

Η Συμμετοχή Του Παγκρέατος Κατά Τας Τραυματικάς Κακώσεις Κοιλίας Εις Την Παιδικήν Ηλικίαν

“…Χορηγείται ενδοφλεβίως και υποδορίως. Η μεγαλύτερη τιμή στον ορό των ασθενών παρατηρείται 30min μετά από υποδόρια χρήση και η δράση της διαρκεί από 3 έως 6 ώρες (Harris, 1993/ Grauer, 1994/ Barnes, 1993.…”