Clinical Evaluation of Terbutaline Sulfate as a Potential Agent for Treating Anastomotic Leakage after Gastric Operation: Effect of Terbutaline Sulfate on Pancreatic Exocrine Secretion

Abstract

Clinical advantage of terbutaline sulfate (Bricanyl®) was evaluated in 6 patients with anastomotic leakage after gastric operation. Terbutaline sulfate was administered subcutaneously for the purpose of inhibiting exocrine pancreatic secretion during 3 or 4 weeks just after anastomotic leakage was recognized by postoperative upper gastrointestinal series (GIS). We first used the conventional treatment for any anastomotic gastric leakage; intravenous hyperalimentation, nasogastric intubation, antibiotics etc. In addition to these conventional treatments, we added terbutaline sulfate to inhibit pancreatic exocrine secretion. With this treatment, exudates from anastomotic leakage and the levels of pancreatic exocrine enzyme were gradually decreased and eventually the injured anastomosis was completely healed in all cases. In conclusion, treatment with terbutaline sulfate could possibly be useful for stopping anastomotic leakage after gastric operation. The important mechanism by which pancreatic exocrine secretion is inhibited by terbutaline sulfate administration may be due to direct action to the acinar cells of the pancreas.