EFFECT OF OCTREOTIDE ON GASTROSTOMY, DUODENOSTOMY, AND CHOLECYSTOSTOMY EFFLUENTS - A PHYSIOLOGICAL STUDY OF FLUID AND ELECTROLYTE BALANCE

Objectives: Octreotide, a somatostatin analog, reduces stool and fistu la outputs by a mechanism that is not completely understood, Our aim w as to study its effect on gastrostomy, duodenostomy, and cholecystosto my effluents in a patient with colorectal cancer. Methods: Effluents o f gastrostomy, duodenostomy, and cholecystostomy were collected in thr ee separate shifts over 24-h periods beginning 3 days before octreotid e therapy and continuing for 15 treatment days, Fifty-four samples wer e tested for volume, pH, acid, and bicarbonate production, and biochem ical profiles, Results: A positive fluid balance was achieved immediat ely with octreotide therapy, Significant decreases in gastrostomy and duodenostomy outputs and in gastric acid production were observed (143 3.33 +/- 33.33 ml/24 h to 535.71 +/- 55.31 ml/24 h, p < 0.0001; 2066.6 7 +/- 66.67 ml/24 h to 247.14 +/- 36.04 ml/24 h, p < 0.0001; and 67.50 +/- 3.20 mEq/h to 13.00 +/- 1.50 mEq/h, p < 0.0001; respectively), Ga strostomy tachyphylaxis was observed after 6 days of treatment, Remark able dose-dependent increases were found in cholesterol and bilirubin concentrations in the cholecystostomy effluent, Conclusions: Octreotid e's primary effect is a decrease in gastric and pancreatic secretions, The increased concentrations of cholesterol and bilirubin may explain the occurrence of gallstones in patients treated with octreotide.