Briceño Delgado F J, López Cillero P, Rufián Peña S, Solórzano Peck G, Miño Fugarolas G, Pera Madrazo C
Departamento de Cirugía, Hospital Reina Sofía, Córdoba.
Rev Esp Enferm Dig. 1998 Oct;90(10):687-94.
This study seeks to evaluate the role of the somatostatin analogue Octreotide as postoperative prophylaxis in the prevention of pancreatic fistula following Pancreaticoduodenectomy (PD).
A prospective and randomized study has been completed in 34 patients undergoing PD. Sixteen patients were randomly assigned to receive Octreotide 0.1 cc (100 mcg) three times daily subcutaneously during the first seven days of the post-operative period and the remaining 18 constituted the control group. All patients were fed parenterally until normal oral feeding was restored (mean 8 days). Fisher's exact test was used to compare complications in both groups. Pancreatic fistula was defined as the persistence of an amylase-rich discharge at least 50 ml daily during a minimum period of two weeks.
The mortality rate was 3% and the morbidity 26%. No significant differences were observed regarding the total number of complications. The appearance of pancreatic fistula was considerably smaller (p = 0.03) in the Octreotide group than in control group. Postoperative hospital stay and the number of subsequent surgical interventions were significantly higher (p < 0.05) in the control group.
Octreotide prevents the occurrence of pancreatic fistula after PD when it is administered prophylactically during the immediate postoperative period.
本研究旨在评估生长抑素类似物奥曲肽在胰十二指肠切除术（PD）后预防胰瘘中的作用。
对34例行PD的患者完成了一项前瞻性随机研究。16例患者被随机分配在术后前7天每天皮下注射奥曲肽0.1 cc（100 mcg），共3次，其余18例组成对照组。所有患者均通过肠外营养直至恢复正常经口喂养（平均8天）。采用Fisher精确检验比较两组的并发症情况。胰瘘定义为至少连续两周每天持续有至少50 ml富含淀粉酶的引流液。
死亡率为3%，发病率为26%。两组在并发症总数方面未观察到显著差异。奥曲肽组胰瘘的发生率明显低于对照组（p = 0.03）。对照组的术后住院时间和后续手术干预次数显著更高（p < 0.05）。
术后即刻预防性使用奥曲肽可预防PD后胰瘘的发生。
