Octreotide treatment in patients with severe acute pancreatitis

We investigated the effect of octreotide in the treatment of severe acute p ancreatitis in a case-control study. Experimental and clinical studies on t he effect of octreotide in the treatment of acute pancreatitis have shown c ontroversial results. Since January 1992, we have been conducting a prospec tive randomized study on the effect of octreotide in severe acute pancreati tis, in three hospitals in Israel. The entering criteria included three or more of the Ranson prognostic signs and CT findings of severe pancreatitis. Patients were randomly assigned to conservative treatment either with or w ithout octreotide (0.1 mg subcutaneously three times a day). The end points of the study included: complication rate (ARDS, sepsis, renal failure, pse udocyst, fistula, and abscess), length of hospital stay, and mortality. Fro m January 1992 to December 1996, 60 patients entered the study. After evalu ating the files, 10 patients were excluded due to failure to meet the enter ing criteria, incomplete data, or incorrect diagnosis. Of the remaining 50 patients, 25 were assigned to octreotide (treatment group) and 25 to conser vative treatment only (control group). The two groups matched with regard t o age, sex, etiology, and severity of the disease. The complication rate wa s lower in the treatment group with regard to sepsis (24% vs 76%, P = 0.000 2) and ARDS (28% vs 56%, P = 0.04). The hospital stay was shorter in the tr eatment group (20.6 vs 33.1 days, P = 0.04). Two patients died in the treat ment group and eight in the control group (P < 0.019). These results sugges t that octreotide may have a beneficial effect in the treatment of severe a cute pancreatitis.