Octreotide inhibits pancreatic exocrine secretion and prevents pancreatoenterostomy leakage

The effects of octreotide, a synthetic somatostatin analogue, were examined in 43 Japanese patients with pylorus-preserving pancreatoduodenectomy. The 43 patients were divided into two groups: 13 patients to whom a daily dose of 100 mu g of octreotide was administered continuously and subcutaneously for the first 10 postoperative days (octreotide group); and 30 patients to whom octreotide was not administered (control group). Within 10 postoperat ive days, pancreatoenterostomy leakage was evident in one (7.7%) of the 13 patients in the octreotide group, but in five (16.7%) of the 30 patients in the control group. The total amount of the pancreatic juice drained extern ally during the first 10 postoperative days was 848 +/- 200 ml in the octre otide group and 1152 +/- 180 ml in the control group. When limited to 20 pa tients who underwent pancreatoenterostomy with total tube drainage, the amo unt of pancreatic juice in 10 patients in the octreotide group examined was 796 +/- 232 ml, which was significantly lower than the 1690 +/- 334 ml in 10 patients in the control group examined (P < 0.05). Of the 10 patients in the octreotide group, the amount of pancreatic juice during postoperative days 6-10 when octreotide was given was reduced to 382 +/- 104 ml compared to 445 +/- 108 ml during postoperative days 11-15 when octreotide was not a dministered (P < 0.05). These findings suggest that subcutaneous injection of octreotide, 100 mu g per day during the first 10 postoperative days, inh ibits pancreatic exocrine secretion and decreases pancreatoenterostomy leak age.