Octreotide Does Not Prevent Postoperative Pancreatic Fistula or Mortality Following Pancreaticoduodenectomy

Barnett, Sean P.; Hodul, Pamela J.; Creech, Steven; Pickleman, Jack; Arahna, Gerard V.
March 2004
American Surgeon;Mar2004, Vol. 70 Issue 3, p222
Academic Journal
The role of octreotide in preventing pancreatic fistula following pancreaticoduodenectomy (PD) remains controversial. The purpose of our study was to report our experience with octreotide in 266 patients undergoing PD from 1995 to 2002. There were 150 males and 116 females. Patients were divided into two groups. Group 1 did not receive octreotide (N = 61). Group 2 received octreotide (N = 205). The average patient age was 66.2 years in the control group and 63.6 years in the octreotide group. One hundred fifty patients were male and 116 were female. Thirty-day mortality for both groups was 1.9 per cent. The incidence of pancreatic fistula was 12 per cent. Fistula occurrence in the octreotide group was 13 per cent and in the no-octreotide group 8 per cent (P = 0.34). Common complications in the no-octreotide group were pancreatic leak (10%), pancreatic fistula (8%), and delayed gastric emptying (8%). Common complications in the octreotide group were pancreatic leak (18%), pancreatic fistula (13%), intra-abdominal abscess (7%), and arrhythmia or myocardial infarction (7%). The only statistically different variable was the incidence of arrhythmia or myocardial infarction (P = 0.026). Octreotide did not reduce pancreatic fistula, other complications, or mortality. Octreotide may contribute cardiac morbidity. Octreotide cannot be recommended to prevent mortality or postoperative complications after PD.


Related Articles

  • Pancreatic Fistula After Pancreaticoduodenectomy Is Iatrogenic in Nature. Shukla, Hari // Indian Journal of Surgery;Oct2015, Vol. 77 Issue 5, p426 

    The article discusses the presence and diagnosis of pancreatic fistula after pancreaticoduodenectomy (PD). It notes that fistula complication not easily accepted by the operative surgeons to be iatrogenic in nature. It then describes and discusses measures to prevent postoperative pancreatic...

  • Hold The Octreotide. Thompson, J. S. // American Journal of Gastroenterology;Jan2001, Vol. 96 Issue 1, p6 

    Provides information on the study "Does Prophylactic Octreotide Decrease the Rates of Pancreatic Fistula and Other Complications After Pancreaticoduodenectomy?," by C. J. Yeo, J. L. Cameron, K. D. Lillenoe et al.

  • The Best Choice to Achieve Zero Complications after Pancreatoduodenectomy. Osada, Shinji; Imai, Hisashi; Sasaki, Yoshiyuki; Yasufuku, Itaru; Asai, Ryuichi; Tokumaru, Yoshihisa; Sakuratani, Takuji; Yoshida, Kazuhiro // Surgical Science;Apr2011, Vol. 2 Issue 2, p45 

    Pancreatoduodenectomy (PD) has been performed commonly, but the occurrence of pancreatic fistula (PF) is a critical trigger of complications, which are potentially life threatening, and is also associated with markedly prolonged hospitalization. Many techniques have been proposed for connecting...

  • Pancreatic fistula after pancreatectomy: Evolving definitions, preventive strategies and modern management. Shrikhande, Shailesh V.; D'Souza, Melroy A.; Llado, Laura // World Journal of Gastroenterology;10/14/2008, Vol. 14 Issue 38, p5789 

    Pancreatic resection is the treatment of choice for pancreatic malignancy and certain benign pancreatic disorders. However, pancreatic resection is technically a demanding procedure and whereas mortality after a pancreaticoduodenectomy is currently < 3%-5% in experienced high-volume centers,...

  • Binding versus conventional pancreaticojejunostomy after pancreaticoduodenectomy: a case-matched study. Maggiori, Léon; Sauvanet, Alain; Nagarajan, Ganesh; Dokmak, Safi; Aussilhou, Béatrice; Belghiti, Jacques; Maggiori, Léon; Aussilhou, Béatrice // Journal of Gastrointestinal Surgery;Sep2010, Vol. 14 Issue 9, p1395 

    Background: Postoperative morbidity of pancreaticoduodenectomy remains high and is mainly related to postoperative pancreatic fistula. Peng et al. (J Gastrointest Surg 2003;7:898-900; Am J Surg 2002;183:283-285; Ann Surg 2007;245:692-298) recently described binding...

  • Systematic Review and Meta-analysis of Enhanced Recovery After Pancreatic Surgery with Particular Emphasis on Pancreaticoduodenectomies. Coolsen, M.; Dam, R.; Wilt, A.; Slim, K.; Lassen, K.; Dejong, C. // World Journal of Surgery;Aug2013, Vol. 37 Issue 8, p1909 

    Background: In the past decade, Enhanced Recovery after Surgery (ERAS) protocols have been implemented in several fields of surgery. With these protocols, a faster recovery and shorter hospital stay can be accomplished without an increase in morbidity or mortality. The purpose of this study was...

  • Predictive risk factors for clinically relevant pancreatic fistula analyzed in 1,239 patients with pancreaticoduodenectomy: multicenter data collection as a project study of pancreatic surgery by the Japanese Society of Hepato-Biliary-Pancreatic Surgery. Kawai, Manabu; Kondo, Satoshi; Yamaue, Hiroki; Wada, Keita; Sano, Keiji; Motoi, Fuyuhiko; Unno, Michiaki; Satoi, Sohei; Kwon, A-Hon; Hatori, Takashi; Yamamoto, Masakazu; Matsumoto, Joe; Murakami, Yoshiaki; Doi, Ryuichiro; Ito, Masahiro; Miyakawa, Shuichi; Shinchi, Hiroyuki; Natsugoe, Shoji; Nakagawara, Hisatoshi; Ohta, Tetsuo // Journal of Hepato -- Biliary -- Pancreatic Sciences;Jul2011, Vol. 18 Issue 4, p601 

    Background/purpose: It is important to predict the development of clinically relevant pancreatic fistula (grade B/C) in the early period after pancreaticoduodenectomy (PD). This study has been carried out as a project study of the Japanese Society of Hepato-Biliary-Pancreatic Surgery (JSHPBS) to...

  • Defining, controlling, and treating a pancreatic fistula. Mahvi, David // Journal of Gastrointestinal Surgery;Jul2009, Vol. 13 Issue 7, p1187 

    The article focuses on the diagnosis and treatment of a postoperative pancreatic leak or fistula after pancreatoduodenectomy. It notes that aggressive drainage of intra-abdominal fluid collections and adequate nutritional support are the important elements of the treatment of a pancreatic leak....

  • EXTERNAL PANCREATIC FISTULA AS A COMPLICATION OF PANCREATICODUODENECTOMY. Starzewski, Jacek; Lorenc, Zbigniew; Owczarski, Krzysztof; Opiłka, Mieszko; Malczyk, Mariusz; Kozera, Jarosław; Brzezińska, Monika // Polish Surgery / Chirurgia Polska;2006 Supplement, Vol. 8, p11 

    Background: Pancreaticoduodenectomy (PD) is the only radical operation for pancreatic head tumors, both malignant and benign. While it is currently decreasing, mortality following PD is still high at over 40%. The most dangerous complication of PD is a leak from the pancreatico- jejunostomy...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics