TREATMENT OF POSTOPERATIVE ENTEROCUTANEOU S FISTULAS WITH OCTREOTIDE,A LONG-ACTING SOMATOSTATIN ANALOG

Two patients with enterocutaneous fistulas (ileal and duodenal) were s uccessfully treated with bowel rest, total parenteral nutrition and th e somatostatine analogue octreotide (150 mu g.day(-1) and 300 mu g.day (-1) respectively). At the time octreotide was started the first patie nt had a high output fistula (1 000 mL.day(-1)), the second had a low output fistula (120 mL.day(-1)). Within 24 hours of treatment, a reduc tion of at least 40 % of the output was observed. The time intervals t o fistula closure were respectively 6 days and 10 days after initiatio n of octreotide therapy. Glucose intolerance was not observed. The eff icacy of octreotide combined with total parenteral nutrition supports its routine use instead of somatostatine, more expensive, less tolerat ed and presenting the risk of rebound effect.