Systematic review and meta-analysis of somatostatin analogues for the treatment of pancreatic fistula

Br J Surg. 2012 Jun;99(6):754-60. doi: 10.1002/bjs.8709. Epub 2012 Mar 20.

Abstract

Background: Somatostatin analogues are used for the treatment of pancreatic fistula, with the aim of achieving fistula closure or reduction of output.

Method: MEDLINE, Embase and Cochrane databases were searched systematically for relevant articles followed by hand-searching of reference lists. Data on patient recruitment, intervention and outcome were extracted and meta-analysis performed where reasonable.

Results: Seven randomized clinical trials met the inclusion criteria and included a total of 297 patients with fistulas of the gastrointestinal tract; of these, 102 patients had fistulas of pancreatic origin. Pooling of closure rates showed no significant difference between patients treated with somatostatin analogues compared with controls: odds ratio 1·52 (95 per cent confidence interval 0·88 to 2·61). Owing to inconsistent descriptions, pooling of results was not possible for other endpoints, such as time to fistula closure.

Conclusion: There is no solid evidence that somatostatin analogues result in a higher closure rate of pancreatic fistula compared with other treatments.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Adult
  • Aged
  • Humans
  • Middle Aged
  • Octreotide / administration & dosage
  • Pancreatic Fistula / drug therapy*
  • Pancreatic Fistula / etiology
  • Peptides, Cyclic / administration & dosage
  • Postoperative Complications / drug therapy
  • Postoperative Complications / etiology
  • Randomized Controlled Trials as Topic
  • Somatostatin / administration & dosage
  • Somatostatin / analogs & derivatives*
  • Treatment Outcome

Substances

  • Peptides, Cyclic
  • lanreotide
  • Somatostatin
  • Octreotide