Efficacy of octreotide in the prevention of complications after pancreaticoduodenectomy in patients with soft pancreas and non-dilated pancreatic duct: A prospective randomized trial

被引:24
作者
El Nakeeb, Ayman [1 ]
ElGawalby, Ahmed [1 ]
Ali, Mahmoud A. [1 ]
Shehta, Ahmed [1 ]
Hamed, Hosam [1 ]
El Refea, Mohamed [1 ]
Moneer, Ahmed [1 ]
El Rafee, Ahmed Abd [1 ]
机构
[1] Mansoura Univ, Gastroenterol Surg Ctr, Mansoura 35516, Egypt
关键词
Pancreaticoduodenectomy; Postoperative pancreatic fistula; Octreotide; Periampullary tumor; FISTULA FOLLOWING PANCREATICODUODENECTOMY; INTERNATIONAL STUDY-GROUP; PROPHYLACTIC OCTREOTIDE; CONTROLLED MULTICENTER; SOMATOSTATIN ANALOGS; RISK-FACTORS; PANCREATICOJEJUNOSTOMY; PANCREATICOGASTROSTOMY; RESECTIONS; MANAGEMENT;
D O I
10.1016/j.hbpd.2018.01.015
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background: The efficacy of octreotide to prevent postoperative pancreatic fistula (POPF) of pancreaticoduodenectomy (PD) is still controversial. This study aimed to evaluate the effect of postoperative use of octreotide on the outcomes after PD. Methods: This is a prospective randomized controlled trial for postoperative use of octreotide in patients undergoing PD. Patients with soft pancreas and pancreatic duct <3 mm were randomized to 2 groups. Group I did not receive postoperative octreotide. Group II received postoperative octreotide. The primary end of the study is to compare the rate of POPF. Results: A total of 104 patients were included in the study and were divided into two randomized groups. There were no significant difference in overall complications and its severity. POPF occurred in 11 patients (21.2%) in group I and 10 (19.2%) in group II, without statistical significance (P = 0.807). Also, there was no significant differences between both groups regarding the incidence of biliary leakage (P = 0.083), delayed gastric emptying (P = 0.472), and early postoperative mortality (P = 0.727). Conclusions: Octreotide did not reduce postoperative morbidities, reoperation and mortality rate. Also, it did not affect the incidence of POPF and its clinically relevant variants. (C) 2018 First Affiliated Hospital, Zhejiang University School of Medicine in China. Published by Elsevier B.V. All rights reserved.
引用
收藏
页码:59 / 63
页数:5
相关论文
共 38 条
[1]  
Allen PJ, 2014, NEW ENGL J MED, V371, P875, DOI [10.1056/NEJMc1407470, 10.1056/NEJMoa1313688]
[2]   Clinical evaluation of somatostatin use in pancreatic resections: Clinical efficacy or limited benefit? [J].
Anderson, Ryan James ;
Dunki-Jacobs, Erik ;
Callender, Glenda G. ;
Burnett, Nick ;
Scoggins, Charles R. ;
McMasters, Kelly M. ;
Martin, Robert C. G., II .
SURGERY, 2013, 154 (04) :755-760
[3]   History of pancreaticoduodenectomy: early misconceptions, initial milestones and the pioneers [J].
Are, Chandrakanth ;
Dhir, Mashaal ;
Ravipati, Lavanya .
HPB, 2011, 13 (06) :377-384
[4]   Postoperative pancreatic fistula: An international study group (ISGPF) definition [J].
Bassi, C ;
Dervenis, C ;
Butturini, G ;
Fingerhut, A ;
Yeo, C ;
Izbicki, J ;
Neoptolemos, J ;
Sarr, M ;
Traverso, W ;
Buchler, M .
SURGERY, 2005, 138 (01) :8-13
[5]  
BAUER W, 1982, LIFE SCI, V31, P1133, DOI 10.1016/0024-3205(82)90087-X
[6]   ROLE OF OCTREOTIDE IN THE PREVENTION OF POSTOPERATIVE COMPLICATIONS FOLLOWING PANCREATIC RESECTION [J].
BUCHLER, M ;
FRIESS, H ;
KLEMPA, I ;
HERMANEK, P ;
SULKOWSKI, U ;
BECKER, H ;
SCHAFMAYER, A ;
BACA, I ;
LORENZ, D ;
MEISTER, R ;
KREMER, B ;
WAGNER, P ;
WITTE, J ;
ZURMAYER, EL ;
SAEGER, HD ;
RIECK, B ;
DOLLINGER, P ;
GLASER, K ;
TEICHMANN, R ;
KONRADT, J ;
GAUS, W ;
DENNLER, HJ ;
WELZEL, D ;
BEGER, HG .
AMERICAN JOURNAL OF SURGERY, 1992, 163 (01) :125-131
[7]   Toward defining grade C pancreatic fistula following pancreaticoduodenectomy: incidence, risk factors, management and outcome [J].
Denbo, Jason W. ;
Orr, W. Shannon ;
Zarzaur, Ben L. ;
Behrman, Stephen W. .
HPB, 2012, 14 (09) :589-593
[8]   Classification of surgical complications - A new proposal with evaluation in a cohort of 6336 patients and results of a survey [J].
Dindo, D ;
Demartines, N ;
Clavien, PA .
ANNALS OF SURGERY, 2004, 240 (02) :205-213
[9]  
El Nakeeb A, 2016, ASIAN J SURG
[10]   Outcomes of pancreaticoduodenectomy in elderly patients [J].
El Nakeeb, Ayman ;
Atef, Ehab ;
El Hanafy, Ehab ;
Salem, Ali ;
Askar, Waleed ;
Ezzat, Helmy ;
Shehta, Ahmed ;
Wahab, Mohamed Abdel .
HEPATOBILIARY & PANCREATIC DISEASES INTERNATIONAL, 2016, 15 (04) :419-427