THERAPY OF ACUTE-PANCREATITIS WITH SOMATOSTATIN

Background: The various conservative measures which have been used to date in the treatment of acute pancreatitis have not proven helpful. However, somatostatin appears to have a favourable effect on the course and outcome of this potentially lethal disease. Method and results: Experiments in animals have shown that somatostatin prevents experimentally induced acute pancreatitis and lowers the mortality rate of established pancreatitis. In human acute pancreatitis, somatostatin reduces gastric and pancreatic secretions; it reduces the local complication rate and shortens hospitalization. The effect of somatostatin on the mortality rate of acute pancreatitis has not been demonstrated in isolated studies, although a meta-analysis of randomized controlled trials has shown a mortality rate of 6.2% in the somatostatin-treated group versus 14.0% in the placebo-treated group. The synthetic analogue of somatostatin, octreotide, is an effective treatment for established local complication of acute pancreatitis, such as pancreatic fistulae and pseudocysts. Conclusion: It is suggested that large-scale, carefully designed multicentre studies of somatostatin are needed if the beneficial effects of this drug on the course and outcome of acute pancreatitis are to be evaluated.