The Effectiveness of the Treatment of Octreotide on Chylous Ascites After Liver Cirrhosis

Abstract

Octreotide is a crucial drug used for treating patients with chylous ascites; however, there have been few reports related to octreotide that are being used in cirrhotic patients. Thus, this thesis is designed to determine the effects of octreotide on patients with chylous ascites after liver cirrhosis. Eight patients were diagnosed with chylous ascites, on the basis of laboratory findings on ascites samples, between January 2003 and May 2008. Octreotide was given to the six patients, while the remaining two were treated as a control. All patients had persistent peritoneal drainage with the quantity and quality of the drainage fluid observed once every other day. All the necessary care was individually given to the patients during the therapy. All patients properly received combined therapy including a low-fat and low-sodium diet, and diuretic and peritoneal drainage. The volume of the peritoneal drainage was reduced to zero in one of the six patients who received octreotide therapy, while the other five had the drainage volumes decreased from 2,000 to 50 ml with a clear appearance and negative qualitative analysis of chyle. For those two patients who did not receive octreotide therapy, the conditions of peritoneal drainage seldom changed both from the qualitative and quantitative aspects. In conclusion, Octreotide, along with combined therapy, can rapidly relieve portal hypertension and reduce triglyceride levels in ascites. It appears to be an effective therapy available for the treatment of chylous ascites caused by liver cirrhosis.

Refractory Ascites after Pancreato-Duodenectomy - Time to Rethink an Old Dogma

“…Although the late onset and prolonged evolution of this ascites were not in favour of this diagnosis, some authors have demonstrated that increased portal pressure, in the cirrhotic liver for example, is a risk factor for chylous ascites [12,13], and the initial clinical course with a diuretic and suitable diet was satisfactory.…”

Effect of Ganoderma Lucidum Pharmacopuncture on Chronic Liver Injury in Rats※

“…And many herbal medicines are now being collected and examined in an attempt to identify possible sources of anti-liver injury. Natural compounds, because of their structural diversity, provide a good opportunity for screening for anti-liver injury agents 21) . In general, pharmacopuncture treatment is performed by injecting small amounts of extracted medicinal materials at acupuncture points or in affected areas in order to obtain combined efficacies of the acupuncture and herb.…”

Management of Chylous Ascites with Octreotide in a Bangladeshi Child: A Case Report

“…Octreotide was first reported to significantly reduce chylous effusion in an adult with chylothorax 13 and subsequently in several other patients with various etiology. [14][15][16][17][18] Octreotide is a somatostatin analogue that inhibits the secretion of some pituitary and gastrointestinal hormones, reduce secretion of fluids from the intestine and pancreas, causes vasoconstriction in the blood vessels& increases splanchnic arteriolar resistance, reducing gastrointestinal flow and consequently the lymph flow. 17 It is a pharmacologic agent that also augments the closure of any leakage in the lymphatic system.…”

“…In addition, variationsregarding octreotide dosing regimens (0.5-8 mcg/kg/h), modes of drug administration (intravenous or subcutaneous), commencement and duration of treatment have beenreported in the literature. 15,16 We used octreotide by intravenous infusion at a rate of 0.5ìg/kg/h and gradually increased to 1 ìg/kg/h on day 3 and continued till day 7 then tapered and discontinued on day 10.Huanget al 8 also used same dose and duration. A dramatic decrease in chyleproduction was observed within 24 hours of infusion, with complete resolution of ascites by 10…”