Systematic review and meta-analysis of somatostatin analogues for the treatment of pancreatic fistula

Gans, Sarah L.; Westreenen, Henderik L. van; Kiewiet, Jordy J. S.; Rauws, E.A.J.; Gouma, Dirk J.; Boermeester, Marja A.

doi:10.1002/bjs.8709

Cited by 102 publications

(51 citation statements)

References 26 publications

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“…For example, concerning a proteolytic enzyme inhibitor that corresponds to the gabexate mesilate used in the present study, Uemura et al described the efficacy of ulinastatin for preventing PF (19). There are more papers about octreotide, including some reviews describing negative conclusions (20)(21)(22). In the present study, three types of medicine were used simultaneously to make the treatment as effective as possible, the administration method of octreotide was changed (continuous venous injection, not subcutaneous injection), and the introduction of TDT was restricted to patients at high risk of PF development.…”

Section: Discussionmentioning

confidence: 87%

Safety and efficacy of early drain removal and triple-drug therapy to prevent pancreatic fistula after distal pancreatectomy

et al. 2015

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Objective: Prior studies suggested that early drain removal prevented the development of pancreatic fistula (PF) after pancreaticoduodenectomy (PD), but there has been no corresponding prospective trial for distal pancreatectomy (DP). The purpose of this study was to determine the safety and efficacy of early drain removal and triple-drug therapy (TDT) with gabexate mesilate, octreotide and carbapenem antibiotics to prevent PF after DP in patients at high-risk of developing PF. Methods:A total 71 patients who underwent a DP were enrolled. We prospectively divided them into two groups: the late-removal group, in which the drain remained in place for at least for 5 days postoperatively (n=30) and the early-removal group in which the drain was removed on postoperative day1 (POD1) (n=41). For the patients with a high drain amylase level (≥ 10,000 IU/L) and patients with symptomatic intraperitoneal fluid collection, our original TDT was introduced. The primary endpoint was the safety and efficacy of this management, and the secondary endpoint was the incidence of PF. Results:The incidence of clinical PF was significantly lower in the early-removal group (0% vs. the late removal 16%; p<0.001). In the early-removal group, TDT was administered to 12 patients (29%) and none of the patients needed additional treatment after TDT. Conclusions:Postoperative management after DP with early drain removal and TDT was safe and effective for preventing PF.

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Section: Discussionmentioning

confidence: 87%

Safety and efficacy of early drain removal and triple-drug therapy to prevent pancreatic fistula after distal pancreatectomy

et al. 2015

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“…11 Although not in a high percentage of cases, in FA are practiced antibiotic therapy (50% in Colleferro) and somatostatin (10% in Cattolica, 70% in Colleferro), which are advisable, according to the recent guidelines, only in local complications (fistula/pseudocyst). 12 Regarding the prognostic and diagnostic phase in OU, after taking care, the APACHE II score early (first 72 h) is practiced in Cattolica and Catanzaro, so as the SIRS evaluation, which is, alone, always practiced in Colleferro. However, no CT severity index was applied in any OU.…”

Section: Clinical Analysis Of Variancesmentioning

confidence: 99%

Acute pancreatitis: confronting to improve

2017

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Our study is a benchmarking on acute pancreatitis, managed in three different Medical Units. The aim of benchmarking is to optimize time and resources by comparing sufficiently homogeneous reality, to identify areas for improvement and to plan appropriate strategies correction. The observation of heterogeneity in terms of clinical aspects and costs in our hospitals, performed through <em>benchmarking</em>, despite our limited case histories, might provide new ideas for future implementation.

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“…Az eredmények arra utalnak, hogy octreotiddal az egyéb kezeléssel eredményesen nem befolyásolható, állandósult, nagy hozamú külső hasnyálmirigysipolyok gyógyulása elősegít-hető [24,25]. A hazai és nemzetközi adatok és a nagy metaanalízisek szerint a perioperatív szomatosztatinanalóg a műtétek után keletkező sipolyok arányát is csök-kenti [22,25,26,27,28,29,30,31,32,33].…”

Section: Hasnyálmirigysipolyokunclassified

Somatostatin and gastrointestinal tract. Clinical experiences

2013

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A szomatosztatin az emésztőrendszerre sokrétűen hat. Gátolja az emésztőrendszeri hormonok felszabadulását, a gyo mor, a hasnyálmirigy és az epe exokrin működését, csökkenti a motilitást és befolyásolja egyes tápanyagok felszívódását is. E sokirányú hatás alapján fokozott várakozás előzte meg a szomatosztatinkezelés eredményessé-gét különböző emésztőrendszeri betegségekben. A szomatosztatinkezelés realitását az elhúzódó hatású analógok (octreotid, lanreotid) kialakítása teremtette meg. Az elmúlt negyed században kiterjedt vizsgálatok tisztázták a szomatosztatinanalógok eredményességét és helyét különböző emésztőrendszeri betegségek kezelésében. A tanulmány az eredmények rövid összefoglalására és értékelésére tesz kísérletet. A kezelés az emésztőrendszer számos kóros álla-potában hatékony, a klinikai gyakorlat részévé azonban csak a neuroendokrin daganatok elsődleges konzervatív, valamint a nyelőcsővisszér-vérzések és a hasnyálmirigysipolyok kiegészítő kezelésében vált. Orv. Hetil., 2013, 154, 1535-1540 Kulcsszavak: szomatosztatin, octreotid, emésztőrendszeri betegségek, nyelőcsővarix-vérzés, hasnyálmirigysipoly Somatostatin and gastrointestinal tract Clinical experiencesThe effect of somatostatin on the gastrointestinal tract is complex; it inhibits the release of gastrointestinal hormones, the exocrine function of the stomach, pancreas and bile, decreases motility and infl uences absorption as well. Based on these diverse effects there was an increased expectation towards the success of somatostatin therapy in various gastrointestinal disorders. The preconditions for somatostatin treatment was created by the development of long acting somatostatin analogues (octreotide, lanreotide). During the last twenty-fi ve years large trials clarifi ed the role of somatostatin analogues in the treatment of various gastrointestinal diseases. This study summarizes shortly these results. Somatostatin analogue treatment could be effective in various pathological conditions of the gastrointestinal tract, however, this therapeutic modality became a part of the clinical routine only in neuroendocrine tumours and adjuvant treatment of oesophageal variceal bleeding and pancreatic fi stulas. Orv. Hetil., 2013, 154, 1535-1540. Keywords: somatostatin, octreotid, gastrointestinal diseases, oesophageal variceal bleeding (Beérkezett: 2013 elfogadva: 2013. szeptember 5.) A szerkesztőség felkérésére készült közlemény. Rövidítések ERCP = retrográd cholangiopancreatographia; EST = endoszkópos szkleroterápia; GIP = gastric inhibitory peptid; LES = alsónyelőcső-sphincter; OGTT = orális glükóztolerancia-teszt; PPI = protonpumpagátló; VIP = vazoaktív intestinalis peptid Szomatosztatin az emésztőrendszerbenA szomatosztatin a legtöbb emberi szervezetben megtalálható, legnagyobb mennyiségben azonban az idegrendszerben és az emésztőrendszerben mutatható ki.

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Systematic review and meta-analysis of somatostatin analogues for the treatment of pancreatic fistula

Abstract: There is no solid evidence that somatostatin analogues result in a higher closure rate of pancreatic fistula compared with other treatments.

Cited by 102 publications

References 26 publications

Safety and efficacy of early drain removal and triple-drug therapy to prevent pancreatic fistula after distal pancreatectomy

Safety and efficacy of early drain removal and triple-drug therapy to prevent pancreatic fistula after distal pancreatectomy

Acute pancreatitis: confronting to improve

Somatostatin and gastrointestinal tract. Clinical experiences

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