OCTREOTIDE ACETATE DECREASES PANCREATIC COMPLICATIONS AFTER PANCREATIC TRAUMA

Octreotide acetate (Sandostatin) has been reported to decrease related morbidity after pancreatic resections. This study examined the use of octreotide after pancreatic trauma. The charts of all patients treate d for pancreatic injuries from June 1988 to February 1992 were reviewe d (n = 28). The mean age of the patients was 29 years (range 16 to 61) . The mechanism of injury was motor vehicle accident in 7 patients, gu nshot wounds in 14, and stab wounds in 7. The mean (+/- SD) abdominal trauma index (ATI) was 33 +/- 14 and injury severity score (ISS) was 2 2 +/- 12. Pancreatic injuries were graded as grade I (contusion) in 6 patients, grade II (parenchymal injury) in 18, and grade III (ductal i njury) in 4. Seven patients (6 grade II and 1 grade III) were treated with prophylactic octreotide acetate, 150 mu g to 300 mu g per day, be ginning on day 1. There were no pancreatic complications in this group . Of the remaining 21 patients, 6 (29%) developed 9 pancreatic complic ations: fluid collections in 3, fistula in 4, pseudocyst in 1, and pan creatitis in 1. Three patients had grade III, 1 had grade II, and 2 ha d grade I injuries. There were no differences in ATI, ISS, or grade of pancreatic injury between patients who were treated with octreotide a nd those who were not. No complications were associated with the use o f octreotide. In conclusion, pancreatic complications occurred frequen tly (21%) following pancreatic trauma and resulted in significant morb idity. In this nonrandomized series of patients with equivalent ATI, I SS, and pancreatic grade injuries, the prophylactic use of octreotide was associated with no pancreatic complications and no negative sequel ae.