Pharmacological Effect of Somatostatin on Bile Secretion in Man

Abstract

Somatostatin (SST) has been shown to induce cholestasis in the dog and in the rat. In man, it is still unknown whether SST modifies bile formation. The present study was undertaken to examine the influence of SST on bile secretion in man. Two volunteers who had a total external biliary fistula received 1-hour SST infusions (3.5 μg/kg/h). Bile flow, bile acid, phospholipid and cholesterol biliary outputs were measured before, during and 1 h after the infusion. The SST infusion was associated with a pronounced decrease in bile flow and in bile acid secretion and with an increase in bile cholesterol saturation. These findings suggest that SST has cholestatic properties in man as in other species. This may provide a rational explanation for the formation of gallstones and for the steatorrhea observed in patients with somatostatinomas or during therapeutic SST administration.

Pancreatic Exocrine and Gallbladder Function during Long-Term Treatment with Octreotide (SMS 201–995)

“…Surpris ingly, in none of 16 acromegalic patients on chronic octreotide treatment were gallstones demonstrated [14]. However, in another study [18], ultrasound examinations in 6 pa tients on chronic octreotide therapy (50 pg octreotide every 8 h) revealed the develop ment of accumulations of thickened bile containing small echodense particles in 4 patients. Gallstones developed within 1 month of therapy in 1 patient [ 18], The Find ing of a significant increase of cholesterol monohydrate crystals and a decrease of nucleation time, together with the development of cholelithiasis in 3 out of 14 patients (13 acromegalics.…”

“…A possible inhibition of he patic bile flow by octreotide similar to native somatostatin further enhances the risk for bile stasis [17,18], a major factor in the pathogenesis of gallstones [19][20][21][22]. Surpris ingly, in none of 16 acromegalic patients on chronic octreotide treatment were gallstones demonstrated [14].…”

Physiology of Cholangiocytes

“…In the human, dog, rat, and mouse, somatostatin inhibits both basal and secretin-stimulated ductal fluid secretion (111,151,169,175,222,224,270). Somatostatin exerts a wide array of physiological effects mediated by five somatostatin receptor subtypes (sst1-sst5) (151,215).…”

Somatostatin for Upper Gastrointestinal Hemorrhage and Pancreatic Surgery

“…Besides inhibition of gastric, pancreatic and biliary [104,105] secretions, there are some other pharmacological actions of somatostatin that might be beneficial in patients with acute pancreatitis. The peptide relaxes the sphincter of Oddi [106,107], thus allowing free drainage of any pancreatic secretion into the duodenum.…”