EFFECTS OF OCTREOTIDE ON POSTPRANDIAL SYSTEMIC AND HEPATIC HEMODYNAMICS IN PATIENTS WITH POSTNECROTIC CIRRHOSIS

The effects of octreotide on postprandial hemodynamic responses were e valuated in 20 patients with postnecrotic cirrhosis. They were randoml y assigned to receive either a 100-mu g bolus with a 100-mu g/h infusi on of octreotide or a placebo. Placebo administration did not affect a ny of the hemodynamic values. However, after a liquid meal of 500 kcal , postprandial increases in the hepatic venous pressure gradient and h epatic blood flow were observed in patients receiving placebo, while t he systemic hemodynamic values remained unchanged. In contrast, in pat ients receiving octreotide, the hepatic blood flow was significantly d ecreased 30 min after administration, while the hepatic venous pressur e gradient and the systemic hemodynamic values were not affected. Afte r ingestion of a meal, the mean values of the hepatic blood flows were not significantly different from basal values. Moreover, the wedged h epatic venous pressure, the hepatic venous pressure gradient and the s ystemic hemodynamic values were not affected by meal ingestion. Howeve r, during octreotide infusion, hepatic blood flow 30 min after the mea l had a tendency to increase compared to before the meal. In conclusio n, octreotide inhibited the postprandial increase in portal pressure i n patients with postnecrotic cirrhosis. In addition, octreotide decrea sed hepatic blood flow in the fasting state. When given before a meal, the increase in blood flow induced by the meal restored the hepatic b lood flow to basal levels. (C) Journal of Hepatology.