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

Hepatobiliary Pancreat Dis Int. 2018 Feb;17(1):59-63. doi: 10.1016/j.hbpd.2018.01.015. Epub 2018 Feb 2.

Abstract

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.

Keywords: Octreotide; Pancreaticoduodenectomy; Periampullary tumor; Postoperative pancreatic fistula.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Egypt / epidemiology
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Octreotide / adverse effects
  • Octreotide / therapeutic use*
  • Pancreatic Ducts* / diagnostic imaging
  • Pancreatic Fistula / diagnosis
  • Pancreatic Fistula / epidemiology
  • Pancreatic Fistula / prevention & control*
  • Pancreaticoduodenectomy / adverse effects*
  • Prospective Studies
  • Risk Factors
  • Time Factors
  • Treatment Outcome
  • Young Adult

Substances

  • Octreotide