The role of somatostatin in 67 consecutive pancreatectomies: a randomized clinical trial

Abstract

Background:Somatostatin has been found to be effective in the prevention of postoperative complications in pancreatic surgery. It can inhibit the pancreatic secretions that, quite often, are responsible for complications during the postoperative period.Methods:We randomized 67 patients in 2 groups. In the study group (n = 35), somatostatin was administered 30 minutes prior to surgery as well as intraoperatively and postoperatively. No medication was given to the control group (n = 32). Biopsies were taken and processed for electron microscopy and ultrastructural morphometric analysis.Results:Administration of somatostatin reduced the exocrine granule number, and the patients suffered from fewer postoperative complications.Conclusions:Somatostatin reduces granule number and size of pancreatic cells, which can partially explain the prophylactic effect of the drug on early complications of pancreatic surgery, and which is confirmed by the clinical findings.

The Use of Prophylactic Somatostatin Therapy Following Pancreaticoduodenectomy: A Meta‐analysis of Randomised Controlled Trials

“…The pooled OR was 0.98 [95% CI 0.57–1.69, p = 0.94] (Fig. 3b). Seven studies reported on infected abdominal collections [17, 18, 20, 22, 24, 25, 27]. This complication was present in 24 (24/413, 5.8%) patients treated with SA and 29 (29/395, 7.3%) patients in the control group.…”

“…The pooled OR was 0.73 [95% CI 0.51–1.05; p = 0.09]. For the six studies [16, 17, 20–22, 26] reported after the 2005 ISGPF classification, the number of cases in the SA group was 68 (68/339, 20.1%) and 99 (99/326, 30.4%) in the control group, respectively. The pooled OR was 0.57 [95% CI, 0.30–1.10, p = 0.09] (Fig.…”

“…We evaluated the possibility of publication bias and demonstrated that studies with positive findings were more likely to be published. Additionally, certain RCTs were sponsored by industry stakeholders [16, 18, 20] and other trials did not clearly state the sources of funding [17, 19, 21].…”

“…Twelve RCTs were included (Fig. 1a) which consisted of 1615 patients [SA-treated group (n = 820) and control group (n = 795)] [ [16][17][18][19][20][21][22][23][24][25][26][27]. There were 784 patients in RCTs comparing octreotide to placebo; 256 patients in trials comparing somatostatin-14 to placebo; 275 patients in trials comparing vapreotide to placebo; and 300 patients in trials comparing pasireotide to placebo [16][17][18][19][20][21][22][23][24][25][26][27].…”

Somatostatin administration following pancreatoduodenectomy: a case-matched comparison according to surgical technique, body mass index, American Society of Anesthesiologists’ score and Fistula Risk Score

“…However, they acknowledged a possible publication bias, as the analysis included papers by authors who did not report separately on the blinding of outcome assessors (detection bias) and claimed to include only PD studies. The studies of Sarr et al [ 32 ], Allen et al [ 33 ], and Katsourakis et al [ 34 ] all included distal pancreatectomy patients.…”