Role of somatostatin and somatostatin analogues in the treatment of gastrointestinal diseases: prevention of complications after pancreatic surgery.

Abstract

Morbidity and mortality related to pancreatic surgery are still high: 30-40% and 3-10% respectively. As most complications are probably related to exocrine pancreatic secretion, its inhibition could improve the postoperative course. In 1979, Klempa saw a low complication rate after Whipple resection in a small number of patients treated with somatostatin, a powerful inhibitor of pancreatic exocrine secretion. The long acting somatostatin analogue, octreotide, also inhibits pancreatic exocrine secretion and can be given by subcutaneous injections. Two double blind, placebo controlled, multicentre studies with randomisation into parallel groups were recently performed to find out if peri and postoperative administration of octreotide (100 micrograms thrice daily subcutaneously) reduces the rate of complications specifically related to pancreatic surgery. Both trials consistently showed that octreotide can reduce substantially (over 40%) the risk of complications in these patients; the treatment acceptability was good.