Octreotide for treatment of postoperative alimentary tract fistulas

• Published in: World journal of surgery 1995-05, Vol.19 (3), p.430-433
• Main Authors: Paran, Haim, Neufeld, David, Kaplan, Ofer, Klausner, Joseph, Freund, Uri
• Format: Article
• Language: English
• Subjects: Anti-Bacterial Agents; Biliary Fistula; Colonic Neoplasms - surgery; Drug Therapy, Combination - therapeutic use; Enterocutaneous Fistula; Humans; Injections, Subcutaneous; Intestinal Fistula - drug therapy; Intestinal Fistula - etiology; Octreotide; Octreotide - administration & dosage; Octreotide - therapeutic use; Pancreatic Fistula; Pancreatic Neoplasms - surgery; Postoperative Complications - drug therapy; Somatostatine; Stomach Neoplasms - surgery
• ISSN: 0364-2313; 1432-2323
• DOI: 10.1007/BF00299182

Eighteen patients with postoperative fistulas of the gastrointestinal tract were treated with the somatostatin analog octreotide between November 1989 and November 1992. Fourteen patients had enterocutaneous fistulas: seven from the duodenum and seven from the ileum. Another three patients had pancreatic fistulas, and one patient had a biliary fistula. Within 24 hours of octreotide treatment, a mean reduction of 52% in the intestinal fistulas' output, 40% in the pancreatic fistulas, and 30% in the biliary fistula was noted. In the intestinal fistulas group the closure rate was 72% after a mean of 11 days. Early closure (mean 6 days) was achieved in all three pancreatic fistulas. In the patient with the biliary fistula a 30% reduction was observed twice following the administration of octreotide, and an increase occurred when it was withheld. The reduction rate of the secretions in high‐output intestinal fistulas (>500 ml/day) was higher than in the low‐output fistulas (63±8% versus 39±4%, p500 ml/j) était plus importante que pour les fistules à bas débit (