Therapy of acute pancreatitis with somatostatin.

BACKGROUND

The various conservative measures which have been used to date in the treatment of acute pancreatitis have not proven helpful. However, somatostatin appears to have a favourable effect on the course and outcome of this potentially lethal disease.

METHOD AND RESULTS

Experiments in animals have shown that somatostatin prevents experimentally induced acute pancreatitis and lowers the mortality rate of established pancreatitis. In human acute pancreatitis, somatostatin reduces gastric and pancreatic secretions; it reduces the local complication rate and shortens hospitalization. The effect of somatostatin on the mortality rate of acute pancreatitis has not been demonstrated in isolated studies, although a meta-analysis of randomized controlled trials has shown a mortality rate of 6.2% in the somatostatin treated group versus 14.0% in the placebo-treated group. The synthetic analogue of somatostatin, octreotide, is an effective treatment for established local complication of acute pancreatitis, such as pancreatic fistulae and pseudocysts.

CONCLUSION

It is suggested that large-scale, carefully designed multi-centre studies of somatostatin are needed if the beneficial effects of this drug on the course and outcome of acute pancreatitis are to be evaluated.