Treatment of pancreatic pseudocysts with percutaneous drainage and octreotide. Work in progress.

In an attempt to decrease catheter drainage of pancreatic pseudocysts, a combined regimen of percutaneous drainage and administration of octreotide acetate was used in eight symptomatic patients. Indications for the combined therapy were pseudocyst recurrence (four patients), pancreatic fistula from percutaneous drainage (two patients), or elective treatment to restrict pancreatic drainage. Octreotide acetate was administered subcutaneously in doses of 50-1,000 micrograms three times a day. The drug was well tolerated and produced only limited adverse effects in four patients: pain at the injection site, hypoglycemia, diarrhea, headaches, and lower-extremity edema (more than one adverse effect was experienced by each patient). The combined use of percutaneous drainage and administration of octreotide was effective in seven patients and failed in one patient who had distal pancreatic duct occlusion. In five patients, catheter drainage decreased to no measurable amount by a mean of 13.8 days. These results suggest octreotide is effective in decreasing the output from pancreatic pseudocysts drained percutaneously.