Somatostatin and analogues in the prevention of postoperative pancreatic fistulae and the treatment of postoperative digestive fistulae.

Somatostatin and analogues exert an extraordinary range of inhibitory effec ts which eventually may have a variety of therapeutic applications. Treamen t of intestinal and pancreatic fistula are the main targets in general and digestive surgery. The perioperative and prophylactic application of somato statin or octreotide in patients who undergo major pancreatic surgery reduc es the postoperative complication rate. This prevention seems indicated fol lowing Whipple procedure in patients with soft pancreatic tissue. The effic acy of somatostatin or analogues in the treatment of intestinal or pancreat ic fistulae is still in debate. Fistula output frequently decreases but clo sure rate, healing time and complications rate are not reduced. The treatme nt and care of patients with high output fistulae may be simplified by soma tostatin or analogues if a positive effect on output is obvious in the firs t days of treatment. (C) 2000 Editions scientifiques ct medicales Elsevier SAS.