TREATMENT OF EXTERNAL BILIARY, PANCREATIC AND INTESTINAL FISTULAS WITH A SOMATOSTATIN ANALOG

Somatostatin and its long-acting analog octreotide (SMS 201-995) inhib it several gastrointestinal functions. Their effects have been studied in the treatment of small numbers of external pancreatic, intestinal and biliary fistulas. We treated 8 biliary, 4 pancreatic and 5 intesti nal cutaneous fistulas with octreotide. Mean decreases in fistula outp ut before octreotide treatment were not significant (p > 0.01 for each group). On the Ist day of octreotide treatment, mean fistula output d ecreased from 412 +/- 60.4 to 234 +/- 57.7 ml in the biliary, from 457 .5 +/- 57.5 to 217.5 +/- 11.8 ml in the pancreatic and from 564 +/- 49 .2 to 217.5 +/- 11.8 ml in the enterocutaneous fistula groups (p < 0.0 1 for each). No serious side effects were recorded. We conclude that o ctreotide is an important adjunct in the conservative treatment of ext ernal biliary, pancreatic and intestinal fistulas, by decreasing their output.