The role of octreotide in preventing complications after pancreatoduodenectomy for cancer

Andrén‐Sandberg, Åke; Flati, G; Büchler, Markus W.

doi:10.1016/s1365-182x(17)30750-5

Cited by 3 publications

(3 citation statements)

References 96 publications

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“…Our literature search identified 13 RCTs and 12 systematic reviews on the effectiveness of somatostatin analogues to reduce pancreatic fistula complications after pancreatic surgery [224–247]. The latest Cochrane review on the effectiveness of somatostatin analogues was published in 2013 [247].…”

Section: Resultsmentioning

confidence: 99%

Guidelines for Perioperative Care for Pancreatoduodenectomy: Enhanced Recovery After Surgery (ERAS) Recommendations 2019

et al. 2020

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Background Enhanced recovery after surgery (ERAS) pathways are now implemented worldwide with strong evidence that adhesion to such protocol reduces medical complications, costs and hospital stay. This concept has been applied for pancreatic surgery since the first published guidelines in 2012. This study presents the updated ERAS recommendations for pancreatoduodenectomy (PD) based on the best available evidence and on expert consensus. Methods A systematic literature search was conducted in three databases (Embase, Medline Ovid and Cochrane Library Wiley) for the 27 developed ERAS items. Quality of randomized trials was assessed using the Consolidated Standards of Reporting Trials statement checklist. The level of evidence for each item was determined using the Grading of Recommendations Assessment Development and Evaluation system. The Delphi method was used to validate the final recommendations. Results A total of 314 articles were included in the systematic review. Consensus among experts was reached after three rounds. A well-implemented ERAS protocol with good compliance is associated with a reduction in medical complications and length of hospital stay. The highest level of evidence was available for five items: avoiding hypothermia, use of wound catheters as an alternative to epidural analgesia, antimicrobial and thromboprophylaxis protocols and preoperative nutritional interventions for patients with severe weight loss ([ 15%). Conclusions The current updated ERAS recommendations for PD are based on the best available evidence and processed by the Delphi method. Prospective studies of high quality are encouraged to confirm the benefit of current updated recommendations.

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Section: Resultsmentioning

confidence: 99%

Guidelines for Perioperative Care for Pancreatoduodenectomy: Enhanced Recovery After Surgery (ERAS) Recommendations 2019

et al. 2020

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“…In our study, octreotide was used perioperatively in selected cases where the soft consistency of the pancreatic parenchyma found intraoperatively and/or a narrow pancreatic duct (<2 mm) was considered to elevate the risk of postoperative PPAP and POPF [38]. The subjective choice of octreotide-treated patients in our study could certainly influence the results and introduce bias.…”

Section: Discussionmentioning

confidence: 99%

“…It is not recommended for routine use in patients undergoing PD because of conflicting study results. Some results indicate its efficacy in reducing the incidence of postoperative complications such as POPF, intraabdominal fluid collections, and PPAP, without any difference in mortality rate [38][39][40]. Others show no benefit or even a negative impact on PD outcomes [41].…”

Section: Discussionmentioning

confidence: 99%

Risk Factors of Postoperative Acute Pancreatitis and Its Impact on the Postoperative Course after Pancreaticoduodenectomy—10 Years of Single-Center Experience

Gajda,

Grudzińska,

Szmigiel

et al. 2023

Life

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Background: Clinically relevant acute postoperative pancreatitis (CR-PPAP) after pancreaticoduodenectomy (PD) is a complication that may lead to the development of local and systemic consequences. The study aimed to identify risk factors for CR-PPAP and assess the impact of CR-PPAP on the postoperative course after PD. Methods: The study retrospectively analyzed data from 428 consecutive patients who underwent PD at a single center between January 2013 and December 2022. The presence of increased amylase activity in plasma, above the upper limit of normal 48 h after surgery, was checked. CR-PPAP was diagnosed when accompanied by disturbing radiological features and/or symptoms requiring treatment. We investigated the relationship between the occurrence of CR-PPAP and the development of postoperative complications after PD, and possible predictors of CR-PPAP. Results: The postoperative follow-up period was 90 days. Of the 428 patients, 18.2% (n = 78) had CR-PPAP. It was associated with increased rates of CR-POPF, delayed gastric emptying, occurrence of intra-abdominal collections, postoperative hemorrhage, peritonitis, and septic shock. Patients who developed CR-PPAP were more often reoperated (37.17% vs. 6.9%, p < 0.0001)) and had increased postoperative mortality (14.1% vs. 5.74%, p < 0.0001). Soft pancreatic parenchyma, intraoperative blood loss, small diameter of the pancreatic duct, and diagnosis of adenocarcinoma papillae Vateri were independent risk factors for CR-PPAP and showed the best performance in predicting CR-PPAP. Conclusions: CR-PPAP is associated with an increased incidence of postoperative complications after PD, worse treatment outcomes, and an increased risk of reoperation and mortality. Pancreatic consistency, intraoperative blood loss, width of the duct of Wirsung, and histopathological diagnosis can be used to assess the risk of CR-PPAP. Amylase activity 48 h after surgery > 161 U/L is highly specific in the diagnosis of CR-PPAP.

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Relationship Between Grade of Fibrosis in Pancreatic Stump and Postoperative Pancreatic Exocrine Activity After Pancreaticoduodenectomy: With Special Reference to Insufficiency of Pancreaticointestinal Anastomosis.

et al. 2002

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The role of octreotide in preventing complications after pancreatoduodenectomy for cancer

Cited by 3 publications

References 96 publications

Guidelines for Perioperative Care for Pancreatoduodenectomy: Enhanced Recovery After Surgery (ERAS) Recommendations 2019

Guidelines for Perioperative Care for Pancreatoduodenectomy: Enhanced Recovery After Surgery (ERAS) Recommendations 2019

Risk Factors of Postoperative Acute Pancreatitis and Its Impact on the Postoperative Course after Pancreaticoduodenectomy—10 Years of Single-Center Experience

Relationship Between Grade of Fibrosis in Pancreatic Stump and Postoperative Pancreatic Exocrine Activity After Pancreaticoduodenectomy: With Special Reference to Insufficiency of Pancreaticointestinal Anastomosis.

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