Segal I, Parekh D, Lipschitz J, Gecelter G, Myburgh J A
Baragwanath Hospital, University of the Witwatersrand, Johannesburg, South Africa.
Digestion. 1993;54 Suppl 1:53-8. doi: 10.1159/000201078.
Prior to the advent of somatostatin conservative therapy for pancreatic fistulas, treatment included intravenous nutritional therapy with nothing per mouth and therapeutic agents to diminish pancreatic secretions. None of these modalities were uniformly successful. A prospective study to evaluate the efficacy of a long-acting somatostatin analogue (Sandostatin) was carried out. 18 patients-10 with pancreatic ascites and 8 with external pancreatic fistulas-were treated. The ascites resolved in 9 of 10 patients in a mean period of 22 days (+/- 3 days). The external fistulas were all high output fistulas and resolved in 7 of 8 patients. Mean period for closure was 23 days. There were no side effects associated with Sandostatin. Sandostatin has made a major impact on the conservative treatment of pancreatic ascites and is an important adjunct to the management of external pancreatic fistulas. It is emphasised however that surgery may be required for the underlying pancreatic disease. In this regard close surveillance of these patients is necessary.
在生长抑素用于胰瘘的保守治疗出现之前，治疗方法包括静脉营养治疗、禁食以及使用减少胰腺分泌的治疗药物。这些方法无一能始终取得成功。一项评估长效生长抑素类似物（善宁）疗效的前瞻性研究得以开展。对18例患者进行了治疗，其中10例为胰性腹水患者，8例为胰外瘘患者。10例胰性腹水患者中有9例腹水在平均22天（±3天）内消退。所有胰外瘘均为高流量瘘，8例患者中有7例瘘口闭合。闭合的平均时间为23天。未发现与善宁相关的副作用。善宁对胰性腹水的保守治疗产生了重大影响，并且是胰外瘘管理的重要辅助手段。然而需要强调的是，对于潜在的胰腺疾病可能需要进行手术治疗。在这方面，对这些患者进行密切监测是必要的。
