THERAPY OF ACUTE-PANCREATITIS WITH SOMATOSTATIN

Background: The various conservative measures which have been used to date in the treatment of acute pancreatitis have not proven helpful. H owever, somatostatin appears to have a favourable effect on the course and outcome of this potentially lethal disease. Method and results: E xperiments in animals have shown that somatostatin prevents experiment ally induced acute pancreatitis and lowers the mortality rate of estab lished pancreatitis. In human acute pancreatitis, somatostatin reduces gastric and pancreatic secretions; it reduces the local complication rate and shortens hospitalization. The effect of somatostatin on the m ortality rate of acute pancreatitis has not been demonstrated in isola ted studies, although a meta-analysis of randomized controlled trials has shown a mortality rate of 6.2% in the somatostatin-treated group v ersus 14.0% in the placebo-treated group. The synthetic analogue of so matostatin, octreotide, is an effective treatment for established loca l complication of acute pancreatitis, such as pancreatic fistulae and pseudocysts. Conclusion: It is suggested that large-scale, carefully d esigned multicentre studies of somatostatin are needed if the benefici al effects of this drug on the course and outcome of acute pancreatiti s are to be evaluated.