Closset Jean, Journe Stephane, Mboti Freddy, El Nakadi Issam, Gelin Michel
Medicosurgical Department of Hepatogastroenterology, ULB Erasme Hospital, Route de Lennik 808, 1070 Brussels, Belgium.
Hepatogastroenterology. 2008 Sep-Oct;55(86-87):1818-23.
BACKGROUND/AIMS: The postoperative morbidity following pancreaticoduodenectomy (PD) remains very high. Somatostatin or octreotide are indicated in the prevention of pancreatic stump-related complications. The aim of this study is to compare the efficacy of somatostatin and octreotide after PD.
Between November 2000 and December 2003 we collected prospectively clinical and biological data from patients with a benign or malignant pancreatic tumor requiring a PD. Fifty patients were randomized into two groups, 25 treated with somatostatin (group S) and 25 with octreotide (group O).
There was no postoperative death. Complications occurred in 20 patients (40%), 11 in group S, 9 in group O (NS). General complications occurred in 7 patients in group S, and 5 patients in group O. Local complications related to the pancreatic stump were found in 4 patients in both groups. At the end of the period of administration of the two study drugs, 2 patients (8%) had a pancreatic fistula in group S and 3 in group O (12%) (p=0.52). A trend of more rapid decreased level of amylase and lipase concentrations in surgical drainage was observed in group S but it is not statistically significant (p=0.29).
In patients requiring PD for pancreatic tumor, somatostatin and octreotide seem to behave similarly in the postoperative period.
背景/目的：胰十二指肠切除术（PD）后的术后发病率仍然很高。生长抑素或奥曲肽可用于预防胰腺残端相关并发症。本研究的目的是比较PD术后生长抑素和奥曲肽的疗效。
在2000年11月至2003年12月期间，我们前瞻性地收集了需要进行PD的良性或恶性胰腺肿瘤患者的临床和生物学数据。50例患者被随机分为两组，25例接受生长抑素治疗（S组），25例接受奥曲肽治疗（O组）。
无术后死亡病例。20例患者（40%）发生并发症，S组11例，O组9例（无统计学差异）。S组7例患者发生全身并发症，O组5例。两组均有4例患者出现与胰腺残端相关的局部并发症。在两种研究药物给药期结束时，S组有2例患者（8%）发生胰瘘，O组有3例（12%）（p = 0.52）。S组手术引流液中淀粉酶和脂肪酶浓度下降趋势更快，但无统计学意义（p = 0.29）。
对于因胰腺肿瘤需要进行PD的患者，生长抑素和奥曲肽在术后的表现似乎相似。
