IS PROPHYLACTIC USE OF OCTREOTIDE BENEFICIAL IN PREVENTING COMPLICATIONS AFTER PANCREATIC SURGERY?

Major complications following pancreatic surgery are related to the digestive exocrine secretions of the gland. Octreotide, a potent inhibitor of the pancreatic secretions may be of value in reducing the complication rate, particularly fistula formation and possibly the mortality after pancreatic surgery. Between Jan 97 and Jun 99, 19 patients who underwent pancreatic surgery were given perioperative Octreotide in a dose of 100 micrograms eight hourly for 7 days starting from the morning of the surgery. The post operative complications were compared with the results of 17 patients who underwent similar pancreatic surgery between Jan 94 to Dec 96 and who were not given perioperative Octreotide. The surgeries conducted in the Octreotide group were pancreatico-duodenectomy 6, lateral pancraetico-jejunostomy 7, pancreatic biopsy 4 and surgery for pancreatic trauma 2. In the non Octreotide group the surgeries done were pancreatico-duodenectomy 7, lateral pancreatico-jejunostomy 6, pancreatic biopsy 3 and surgery for pancreatic trauma 2. Only 1 out of 19 patients in the Octreotide group developed pancreatic fistula. This was after a pancreaticoduodenectomy and closed spontaneously after 7 days. In the non Octreotide group 5 out of 17 patients developed pancreatic fistula. Of these 5, 1 patient died while in remaining 4 the mean fistula closure time was 23 days. Octreotide reduces the incidence of pancreatic fistula after pancreatic surgeries. However, a larger prospective study is required to convincingly prove the efficacy of Octreotide in prevention of pancreatic fistula after pancreatic surgery.