The effects of somatostatin and octreotide on experimental and human acutepancreatitis

The role of somatostatin and octreotide for AP has been studied for two dec ades, yet the data still remain inconclusive, The inconsistencies of the re sults of experimental studies and clinical trials may stem from the fact th at the optimal therapeutic modality has not been determined. Furthermore, a lthough they are similar in structure and physiologic activities, the mecha nisms of action and effects of somatostatin and octreotide in AP may be dif ferent. Because the data are sparse, most reports, primarily those in the E nglish literature, on the efficacy of somatostatin and octreotide in the ma nagement of AP were reviewed. Included are both nonrandomized and prospecti ve, double-blind, clinical trials and studies on the effects of these agent s on various experimental models of the disease. The results of the studies on somatostatin and octreotide are presented and discussed separately, wit h specific reference to the experimental and treatment details, The main fo cus of the review is the effect of subcutaneous and intravenous administrat ion of octreotide. Analysis of the data suggests that somatostatin could no t be recommended for AP and that the efficacy of subcutaneous administratio n of octreotide is also questionable, Theoretically, intravenous octreotide may be more appropriate for this condition, but recent results with this t herapeutic method are limited and contradictory. Studies that would delinea te the optimal therapeutical modality and the patient population most likel y to respond to the treatment are prerequisite for large-scale clinical tri als on the effects of octreotide on human pancreatitis.