Use of somatostatin in the treatment of digestive fistulas - Pharmacoeconomic issues

The management of high-cost surgical patients with digestive fistulas is a major health problem. Second to total parenteral nutrition, somatostatin ha s been considered the most dramatic advance in the control of fluid, electr olyte and nutritional embarrassment caused by such fistulas. Native somatos tatin, first isolated in 1973, is a 14-amino acid peptide with a half-life of 1-3 min, and numerous inhibitory effects on the secretion of digestive f luids. Several nonrandomized trials have shown that somatostatin enhances t he closure rate and reduces the time to closure of almost all types of dige stive fistulas. Somatostatin, if used appropriately, seems to be associated with overall cost savings mainly by decreasing the length of hospital stay . Prospective controlled trials are expected to confirm these findings in t he near future. Copyright (C) 1999 S. Karger AG. Basel.