Miller B M, Traverso L W, Freeny P C, Abumrad N N
Department of Surgery, Virginia Mason Medical Center, Seattle, WA 98111.
Int J Pancreatol. 1989 Feb;4(1):65-72. doi: 10.1007/BF02924148.
Somatostatin has been reported to promote closure of pancreatic fistulae, but use of the analog SMS 201-995 (Sandoz, Inc.) has not previously been published. We used this analog to treat two patients with end pancreatic fistulae refractory to conventional therapy. One patient had disruption of a pancreaticojejunostomy after pancreaticoduodenectomy and the other had acute necrotizing gallstone pancreatitis and disruption of the pancreatic duct in the tail. SMS 201-995 (100-150 micrograms/d) abruptly decreased fistula output by 50% in both patients but further increases in dosage had no further effect on output. Neither fistula healed after 3-4 wk of therapy. Treatment with somatostatin or its analogs alone will not lead to closure of a pancreatic fistula complicated by factors such as distal obstruction, infection, or foreign body. Somatostatin may promote closure of lateral fistulae and may simplify the management of patients with high output fistulae.
据报道，生长抑素可促进胰瘘闭合，但此前尚未发表使用类似物SMS 201-995（山德士公司）的相关报道。我们使用这种类似物治疗了两名传统治疗无效的胰尾部瘘患者。一名患者在胰十二指肠切除术后胰空肠吻合口破裂，另一名患者患有急性坏死性胆石性胰腺炎且胰尾胰管破裂。SMS 201-995（100 - 150微克/天）使两名患者的瘘液排出量均突然减少50%，但进一步增加剂量对排出量并无进一步影响。治疗3 - 4周后，两个瘘口均未愈合。单独使用生长抑素或其类似物治疗不会使伴有远端梗阻、感染或异物等因素的胰瘘闭合。生长抑素可能促进侧方瘘的闭合，并可能简化高排出量瘘患者的管理。
