C. Gouillat et al., Randomized controlled multicentre trial of somatostatin infusion after pancreaticoduodenectomy, BR J SURG, 88(11), 2001, pp. 1456-1462
Background: It remains debatable whether somatostatin can prevent pancreati
c fistula and other pancreatic stump-related complications following pancre
aticoduodenectomy. This study assessed the effects of somatostatin-14 (S-14
) on pancreatic remnant exocrine secretion.
Methods: This was a double-blind, randomized, placebo-controlled trial in p
atients undergoing pancreaticoduodenectomy for malignancy. Patients receive
d a continuous infusion of S-14 (n=38) or placebo (n=37) for 7 days. Pancre
atic juice and peripancreatic drainage fluid was collected and measured, an
d pancreatic enzymes were monitored daily. Postoperative complications were
recorded.
Results: S-14 infusion was associated with a decrease in median daily pancr
eatic juice and pancreatic amylase output. Amylase concentration and output
in the peripancreatic drain fluid were significantly lower after S-14 infu
sion than in the control group (both P<0.05). The incidence of clinical pan
creatic fistula (two of 38 versus eight of 37; P<0.05) and total pancreatic
stump-related complications (five of 38 versus 12 of 37; P<0.05) was lower
in patients treated with S-14. Duration of hospital stay was shorter after
S-14 (18 versus 26 days; P=0.01).
Conclusion: Although the effect of S-14 on exocrine secretion remains diffi
cult to demonstrate, it did reduce pancreatic juice leakage from the pancre
atic remnant.