Efficacy of the Long-Acting Repeatable Formulation of the Somatostatin Analogue Octreotide in Postoperative Dumping

Arts, Joris; Caenepeel, Philip; Bisschops, Raf; Dewulf, Dominiek; Holvoet, Lieselot; Piessevaux, Hubert; Bourgeois, Stefan; Sifrim, Daniel; Janssens, Jozef; Tack, Jan

doi:10.1016/j.cgh.2008.11.025

Cited by 113 publications

(142 citation statements)

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“…Somatostatin analogs such as octreotide have been used successfully in the treatment of early dumping syndrome [12][13][14][15], although octreotide does have problems, including being expensive and having adverse events, such as gallstone formation, prolonged QT and such as postprandial hyperglycemia. The data shown here suggest that increased secretion of GLP-1 and GIP might be an alternative mechanism leading to the occurrence of early dumping syndrome.…”

Section: Discussionmentioning

confidence: 99%

Octreotide improves early dumping syndrome potentially through incretins: a case report

et al. 2013

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Dumping synDrome, or rapid gastric emptying, is a serious complication that may occur after gastric surgery in approximately 5-10% of patients, although it may occur in approximately 20% after vagotomy with pyloroplasty and up to 50% after esophagectomy [1][2][3]. In spite of this level of occurrence, the pathophysiologic mechanisms underlying the symptoms of dumping syndrome are poorly understood. Here, we report a patient with dumping syndrome following distal gastrectomy with Billroth I reconstruction for early-stage gastric cancer. In this case, we have measured the levels of several hormones during a 75g oral glucose tolerance test (75g-OGTT), and found that glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) were both inhibited by octreotide treatment. Abstract. Dumping syndrome, or rapid gastric emptying, is a frequent complication after gastric surgery. In this case, the patient was a 47-year-old woman who 10 years previously had undergone distal gastrectomy with Billroth I reconstruction for early-stage gastric cancer. She presented with symptoms of weakness, headache, palpitation, sweating, dizziness and significant fatigue between one and two hours after a meal. Because a 75g oral glucose tolerance test (75g-OGTT) induced both acute postprandial tachycardia (within 1 hour) and postprandial hypoglycemia, we diagnosed this patient with early and late dumping syndrome. Dietary measures and acarbose improved symptoms of late dumping syndrome but did not prevent the symptoms of early dumping syndrome such as postprandial tachycardia, weakness, headache, palpitation, and dizziness. We therefore used the somatostatin analogue octreotide, which has been reported as an effective therapy for early dumping syndrome. Octreotide prevented the symptoms of early dumping syndrome, especially postprandial tachycardia, but caused postprandial hyperglycemia. Glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) were completely suppressed during the 75g-OGTT following subcutaneous injection of octreotide. No change was observed in vasoactive intestinal polypeptide (VIP), which is the gastrointestinal peptide hormone generally responsible for early dumping syndrome, suggesting possible contribution of incretins in early dumping syndrome of this patient.Key words: Dumping syndrome, GLP-1, Octreotide material and methods Laboratory analysesBlood samples were taken after an overnight fast. Plasma glucose concentrations were measured with the hexokinase G6PD UV method. Serum insulin concentrations were measured with a chemiluminescent enzyme immunoassay. Serum triglyceride concentrations were determined by Enzymatic method. Serum total cholesterol concentrations were measured by a cholesterol dehydrogenase ultraviolet method. Serum HDL cholesterol concentrations were determined by a direct method (Cholestest ® N HDL, Sekisui Medical, Japan). Hemoglobin A1c (NGSP) levels were measured by high performance liquid chromatographic assay (HPLC). Serum total GIP and...

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Section: Discussionmentioning

confidence: 99%

Octreotide improves early dumping syndrome potentially through incretins: a case report

et al. 2013

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“…Enkelte pasienter har begge former (1). Plagene forekommer normalt ikke ved faste, og intensiteten av symptomene kan graderes (5,6).…”

Section: Symptombildeunclassified

“…Kvalme, luftplager, abdominalkramper, smerter, og (eksplo-OVERSIKTSARTIKKEL siv) diaré er vanlige gastrointestinale symptomer, mens rødme, varmefølelse, svimmelhet, blodtrykksfall og økt hjertefrekvens (hjertebank) kan vaere typiske vasomotoriske reaksjoner. Mange opplever symptomlindring ved å legge seg ned (5,6).…”

Section: Symptombildeunclassified

“…Om man tar med lette symptomer eller kun uttalte plager, og når i forløpet etter operasjonen pasientene evalueres, har betydning. Det bør tilstrebes reproduserbare kriterier for definisjon og gradering av symptomenes intensitet samt objektive effektmål av intervensjon (6,16).…”

Section: Diskusjonunclassified

“…Dette er også vår erfaring når pasientene som opereres for sykelig fedme får informasjon gjennom preoperativ kursing og postoperativ oppfølging. Fokus på plagene og ernaeringsstatus kan ha betydning for livskvalitet og redusere risiko for senbivirkninger (6,17). Plagene kan bidra til endrede matpreferanser, og det er et viktig mål i oppfølgingen å sikre et naeringsrikt kosthold.…”

Section: Diskusjonunclassified

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Dumpingsyndrom etter kirurgi på magesekken

Mala¹,

Hewitt²,

Høgestøl³

et al. 2015

Tidsskriftet

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Hilde RisstadVentrikkelkirurgi inkluderer blant annet behandling av kreft i mage, spiserør og bukspyttkjertel, gastroøsofageal reflukssykdom og sykelig fedme. Operativ behandling av ulcussykdom var tidligere vanlig årsak til dumpingsyndrom, men utføres nå sjelden. Det opereres omkring 250 pasienter årlig med kurativ intensjon for kreft i spiserør og magesekk i Norge. Fedmekirurgi er imidlertid den vanligste årsaken til dumpingsyndrom i dag. Antallet som opereres for sykelig fedme har vaert økende siden 2004 og utgjør nå ca. 3 000 pasienter årlig i Norge. Anslagsvis 3 /4 av disse opereres med gastrisk bypass.Samlet omfatter disse inngrepene et betydelig antall pasienter. Med bakgrunn i våre erfaringer, spesielt med pasienter som er operert for sykelig fedme, ønsker vi med denne artikkelen å beskrive fenomenet dumpingsyndrom og diagnostikk og behandling av tilstanden, da helsepersonell vil møte disse pasientene i ulike sammenhenger. KunnskapsgrunnlagVi søkte etter engelsk-og norskspråklige original-og oversiktsartikler i PubMed med bruk av søkekombinasjoner som «dumping», «dumping syndrome», «dumping and gastrointestinal surgery»,«dumping and gastrectomy», og «dumping and bariatric surgery». Det ble ikke gjort begrensninger bakover i tid. Sammendrag og/eller hele artikler identifisert ved bruk av søkekombinasjonene ble evaluert. Vi inkluderte artikler som vi vurderte som saerlig relevant for beskrivelse av forekomst, symptomatologi og behandling. Vi har også med egne kliniske erfaringer fra pasientgruppen.

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Gastric Motility Disorders

Tack

2012

Textbook of Clinical Gastroenterology and Hepatology

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Efficacy of the Long-Acting Repeatable Formulation of the Somatostatin Analogue Octreotide in Postoperative Dumping

Cited by 113 publications

References 34 publications

Octreotide improves early dumping syndrome potentially through incretins: a case report

Octreotide improves early dumping syndrome potentially through incretins: a case report

Dumpingsyndrom etter kirurgi på magesekken

Gastric Motility Disorders

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