OCTREOTIDE THERAPY FOR PANCREATICOPLEURAL FISTULA

Pancreaticopleural fistula is a rare but remediable complication of pa ncreatitis. Hitherto, treatment by means of total parenteral nutrition and thoracocentesis had resulted in an overall success rate of 40% on ly. Surgical obliteration of persistent fistulae is required in many c ases, as the underlying pancreatic duct lesion often prevents spontane ous closure of the fistula. We report a patient suffering from pancrea ticopleural fistula with a tightly strictured pancreatic duct. The fis tula was successfully obliterated with the use of octreotide addition to thoracocentesis and total parenteral nutrition. Pancreatic bypass s urgery was later performed only for pain relief We believe that octreo tide can effectively suppress pancreatic secretion and promote closure of pancreaticopleural fistula even in the presence of severe pancreat ic duct lesions. Thus the risk of infection and early surgery for pers istent fistula can be minimized.