Evaluation of somatostatin or octreotide efficacy in the treatment of external pancreatic fistulas

Aim of the study To evaluate the prevalence of pancreatic pseudocyst after persistent fistula closure with somatostatin or octreotide. To compare the patient characteristics according to the subsequent presence or absence of pseudocyst Patients and methods: This retrospective study from January 1994 to August 1999 included 15 patients with an external pancreatic fistula, Fistula clos ure was observed for all patients with somatostatin or octreotide. CT scan was performed 66 +/- 34 days after the end of this treat ment. Result: CT scan was normal in 9 patients (favorable group) and showed pancr eatic pseudocyst (failure group) in 6 patients. Pancreatic fistula etiologi es were different between the two groups. The 5 patients presenting pancrea tic fistula after duodenopancreatectomy belonged to the favorable group. SI X Of the 10 patients presenting pancreatic fistula after pseudocyst drainag e belonged to the failure group. There were no ether differences between th e two groups. Conclusion: Persistent pancreatic fistula can be cared with somatostatin or octreotide. However, fistulas occurring after duodenopancreatectomy are mo re easily cured with somatostatin or octreotide than fistulas occurring aft er external pseudocyst drainage. Somatostatin or octreotide cannot be consi dered to be an effective treatment for pancreatic fistula occurring after p seudocyst drainage, despite the fact that 40% of them were permanently cure d. (C) 2001 Editions scientifiques et medicales Elsevier SAS.