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Octreotide and fistulae

E V Stepan, A S Ermolov, M L Rogal', Yu S Teterin
The main principles of treatment of external postoperative pancreatic fistulas are viewed in the article. Pancreatic trauma was the reason of pancreatic fistula in 38.7% of the cases, operations because of acute pancreatitis - in 25.8%, and pancreatic pseudocyst drainage - in 35.5%. 93 patients recovered after the treatment. Complex conservative treatment of EPF allowed to close fistulas in 74.2% of the patients with normal patency of the main pancreatic duct (MPD). The usage of octreotide 600-900 mcg daily for at least 5 days to decrease pancreatic secretion was an important part of the conservative treatment...
2017: Khirurgiia
Yun-Peng Peng, Xiao-Le Zhu, Ling-Di Yin, Yi Zhu, Ji-Shu Wei, Jun-Li Wu, Yi Miao
Postoperative pancreatic fistula (POPF) is a common complication following distal pancreatectomy (DP). However, the risk factors of this complication in patients after DP still remain controversial. The aim of our study is to estimate the association between potential risk factors and POPF. Relevant articles published up to June 21, 2016 were identified via PubMed, EMBASE, Web of Science, and The Cochrane Library. Studies that examined the risk factors of POPF following DP were enrolled. 20 articles (2070 patients) were finally included in this study...
March 15, 2017: Scientific Reports
M D Dibirov, L V Domarev, E A Shitikov, A I Isayev, G S Karsotiyan
INTRODUCTION: Pancreatic necrosis - acute surgical disease accompanying high rates of mortality and complications. MATERIAL AND METHODS: The analysis of the treatment of 256 patients with pancreatic necrosis moderate and severe degrees. In the control group was conducted basic therapy, the main (n=158), which further were administered high doses of octreotide and endoscopic stenting of the main pancreatic duct to decrease the intraductal pressure, prevention and treatment of internal pancreatic fistula...
2017: Khirurgiia
Matthew T McMillan, Amer H Zureikat, Melissa E Hogg, Stacy J Kowalsky, Herbert J Zeh, Michael H Sprys, Charles M Vollmer
Importance: The adoption of robotic pancreatoduodenectomy (RPD) is gaining momentum; however, its impact on major outcomes, including pancreatic fistula, has yet to be adequately compared with open pancreatoduodenectomy (OPD). Objective: To demonstrate that use of RPD does not increase the incidence of clinically relevant pancreatic fistula (CR-POPF) compared with OPD. Design, Setting, and Participants: Data were accrued from 2846 patients who underwent pancreatoduodenectomies (OPDs, n = 2661; RPDs, n = 185), performed by 51 surgeons at 17 institutions worldwide (2003-2015)...
April 1, 2017: JAMA Surgery
Vanessa Phillis Ho, Nimitt J Patel, Faran Bokhari, Firas G Madbak, Jana E Hambley, James R Yon, Bryce R H Robinson, Kimberly Nagy, Scott B Armen, Samuel Kingsley, Sameer Gupta, Frederic L Starr, Henry R Moore, Uretz J Oliphant, Elliott R Haut, John J Como
BACKGROUND: Traumatic injury to the pancreas is rare but is associated with significant morbidity and mortality, including fistula, sepsis, and death. There are currently no practice management guidelines for the medical and surgical management of traumatic pancreatic injuries. The overall objective of this article is to provide evidence-based recommendations for the physician who is presented with traumatic injury to the pancreas. METHODS: The MEDLINE database using PubMed was searched to identify English language articles published from January 1965 to December 2014 regarding adult patients with pancreatic injuries...
January 2017: Journal of Trauma and Acute Care Surgery
Jin-Young Jang, Yong Chan Shin, Youngmin Han, Joon Seong Park, Ho-Seong Han, Ho Kyoung Hwang, Dong Sup Yoon, Jae Keun Kim, Yoo Seok Yoon, Dae Wook Hwang, Chang Moo Kang, Woo Jung Lee, Jin Seok Heo, Mee Joo Kang, Ye Rim Chang, Jihoon Chang, Woohyun Jung, Sun-Whe Kim
Importance: The rate of postoperative pancreatic fistula (POPF) after distal pancreatectomy ranges from 13% to 64%. To prevent POPF, polyglycolic acid (PGA) mesh was introduced, but its effect has been evaluated only in small numbers of patients and retrospective studies. Objective: To evaluate the efficacy of PGA mesh in preventing POPF after distal pancreatectomy. Design, Setting, and Participants: Prospective randomized clinical, single-blind (participant), parallel-group trial at 5 centers between November 2011 and April 2014...
February 1, 2017: JAMA Surgery
Koji Takeuchi, Takuya Endoh, Shusaku Hayashi, Takeshi Aihara
BACKGROUND/AIM: Muscarinic acetylcholine receptors exist in five subtypes (M1∼M5), and they are widely expressed in various tissues to mediate diverse autonomic functions, including gastric secretion. In the present study, we demonstrated, using M1∼M5 KO mice, the importance of M4 receptors in carbachol (CCh) stimulation of acid secretion and investigated how the secretion is modulated by the activation of M4 receptors. METHODS: C57BL/6J mice of wild-type (WT) and M1-M5 KO were used...
2016: Frontiers in Pharmacology
Jin-Hang Gao, Shi-Lei Wen, Shi Feng, Wen-Juan Yang, Yao-Yao Lu, Huan Tong, Rui Liu, Shi-Hang Tang, Zhi-Yin Huang, Ying-Mei Tang, Jin-Hui Yang, Hui-Qi Xie, Cheng-Wei Tang
Abnormal angiogenesis is critical for portal hypertension in cirrhosis. Except for etiological treatment, no efficient medication or regime has been explored to treat the early stage of cirrhosis when angiogenesis is initiated or overwhelming. In this study, we explored an anti-angiogenesis effort through non-cytotoxic drugs octreotide and celecoxib to treat early stage of cirrhotic portal hypertension in an animal model. Peritoneal injection of thioacetamide (TAA) was employed to induce liver cirrhosis in rats...
October 2016: Angiogenesis
Thilo Welsch, Benjamin Müssle, Marius Distler, Holger Knoth, Jürgen Weitz, Dennis Häckl
PURPOSE: Postoperative pancreatic fistula (POPF) is a major determinant of pancreatic surgery outcome, and prevention of POPF is a relevant clinical challenge. The aim of the present study is to compare the cost-effectiveness of octreotide and pasireotide for POPF prophylaxis. METHODS: A systematic literature review and meta-analysis and a retrospective patient cohort provided the data. Cost-effectiveness was calculated by the incremental cost-effectiveness ratio (ICER) and by decision tree modelling of hospital stay duration...
November 2016: Langenbeck's Archives of Surgery
Elena González-Sánchez-Migallón, José Aguilar-Jiménez, José Andrés García-Marín, José Luis Aguayo-Albasini
Chyle leak following axillary lymph node clearance is a rare yet important complication. The treatment of postoperative chyle fistula still remains unclear. Conservative management is the first line of treatment. It includes axillary drains on continuous suction, pressure dressings, bed rest, and nutritional modifications. The use of somatostatin analogue is well documented as a treatment for chylous fistulas after neck surgery. We present a case of chylous fistula after axillary surgery resolved with the use of octreotide...
2016: Case Reports in Surgery
Noela Carrera-Guermeur, Rosa M Martín-Crespo, Hilda J Ramírez, Ángel Pantoja, Rafael Luque-Mialdea
UNLABELLED: Enterocutaneous fistula and its conservative management still pose a challenge for the surgeon. The use of octreotide and somatostatin in neonates and children as adjunctive therapy in the conservative management of this condition, leads to major controversy regarding its efficacy. Therefore, we conducted an extensive literature review of published articles regarding the use of somatostatin and its analogues in the treatment of enterocutaneous fistula in neonates and children...
March 2016: European Journal of Pediatrics
Rui Kong, Jisheng Hu, Le Li, Gang Wang, Hua Chen, Xuewei Bai, Yongwei Wang, Linfeng Wu, Hongchi Jiang, Bei Sun
OBJECTIVE: To investigate the effect of utilizing octreotide during perioperative period on pancreatic fistula after pancreaticoduodenectomy (PD). METHODS: Three hundreds and six patients admitted from January 2010 to October 2014, who prepared to undergo pancreaticoduodenectomy (PD) were randomly divided into octreotide group (147 cases) and control group (159 cases). In octreotide group, octreotide was used in subcutaneous injection instantly after PD, each 8 hours until postoperative 10(th) day, and patients in control group were injected with the same volume of saline...
January 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
M C Giglio, D R C Spalding, A Giakoustidis, A Zarzavadjian Le Bian, L R Jiao, N A Habib, M Pai
BACKGROUND: Drain amylase content in the days immediately after major pancreatic resection has been investigated previously as a predictor of postoperative pancreatic fistula (POPF). Its accuracy, however, has not been determined conclusively. The purpose of this study was to evaluate the accuracy of drain amylase content on the first day after major pancreatic resection in predicting the occurrence of POPF. METHODS: A literature search of the MEDLINE, Embase and Scopus(®) databases to 13 May 2015 was performed to identify studies evaluating the accuracy of drain amylase values on day 1 after surgery in predicting the occurrence of POPF...
March 2016: British Journal of Surgery
Matthew T McMillan, Sameer Soi, Horacio J Asbun, Chad G Ball, Claudio Bassi, Joal D Beane, Stephen W Behrman, Adam C Berger, Mark Bloomston, Mark P Callery, John D Christein, Elijah Dixon, Jeffrey A Drebin, Carlos Fernandez-Del Castillo, William E Fisher, Zhi Ven Fong, Michael G House, Steven J Hughes, Tara S Kent, John W Kunstman, Giuseppe Malleo, Benjamin C Miller, Ronald R Salem, Kevin Soares, Vicente Valero, Christopher L Wolfgang, Charles M Vollmer
OBJECTIVE: To evaluate surgical performance in pancreatoduodenectomy using clinically relevant postoperative pancreatic fistula (CR-POPF) occurrence as a quality indicator. BACKGROUND: Accurate assessment of surgeon and institutional performance requires (1) standardized definitions for the outcome of interest and (2) a comprehensive risk-adjustment process to control for differences in patient risk. METHODS: This multinational, retrospective study of 4301 pancreatoduodenectomies involved 55 surgeons at 15 institutions...
August 2016: Annals of Surgery
Abhishek Mitra, Ashwin D'Souza, Mahesh Goel, Shailesh V Shrikhande
Surgical resection for pancreatic and periampullary cancer has evolved over several decades. The postoperative mortality for these resections has declined to less than 5 %. However, morbidity associated with these resections is still considerable. Various technical modifications like pylorus preservation, reconstruction techniques and methods to perform pancreaticoenteric anastomosis have been suggested to improve postoperative outcomes after pancreaticoduodenectomy. Surgical modifications to improve oncological clearance and decrease fistula rates after distal pancreatic resections have also been suggested...
October 2015: Indian Journal of Surgery
Prakash Kurumboor, Kamalesh Nadothottam Palaniswami, K Pramil, Deepak George, Shaji Ponnambathayil, Deepak Varma, Sylesh Aikot
BACKGROUND: Whether octreotide prevents pancreatic fistula following pancreatoduodenectomy is controversial and it is believed to be beneficial in soft glands and normal-sized ducts. The aim of this study is to assess the potential value of octreotide in reducing the incidence of pancreatic fistula, postoperative complications, morbidity and hospital stay in patients with soft pancreas and non-dilated ducts. METHODS: A total of 109 patients undergoing elective pancreatoduodenectomy with soft pancreas and non-dilated duct were randomized to octreotide group versus no octreotide-the control group...
November 2015: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Dongbin Ahn, Jin Ho Sohn, Ji Yun Jeong
BACKGROUND: Chyle fistula is a relatively rare complication of neck dissection, and there is a lack of consensus regarding its incidence, risk factors, and management. METHODS: Between 2007 and 2014, a total of 472 cases of neck dissection involving the level IV compartment were included in the study. The incidence, risk factors, and clinical course of chyle fistula were investigated, as well as the outcomes of conventional management and the use of octreotide injection in high-output chyle fistula...
December 2015: Annals of Surgical Oncology
Mark S Swanson, Rachael L Hudson, Nipun Bhandari, Uttam K Sinha, Dennis R Maceri, Niels Kokot
IMPORTANCE: Chyle fistula is an uncommon complication of neck surgery. A variety of management strategies have been described, including diet restriction, parenteral nutrition, use of pressure dressings, and revision surgery. Octreotide has been used with success in patients with neck and thoracic chyle fistulas, but data regarding efficacy in neck chyle fistulas are lacking. OBJECTIVE: To evaluate the efficacy of octreotide for use in patients with postoperative chyle fistulas...
August 2015: JAMA Otolaryngology—Head & Neck Surgery
Tomohiko Adachi, Tamotsu Kuroki, Amane Kitasato, Masataka Hirabaru, Hajime Matsushima, Akihiko Soyama, Masaaki Hidaka, Mitsuhisa Takatsuki, Susumu Eguchi
OBJECTIVE: Prior studies suggested that early drain removal prevented the development of pancreatic fistula (PF) after pancreaticoduodenectomy (PD), but there has been no corresponding prospective trial for distal pancreatectomy (DP). The purpose of this study was to determine the safety and efficacy of early drain removal and triple-drug therapy (TDT) with gabexate mesilate, octreotide and carbapenem antibiotics to prevent PF after DP in patients at high-risk of developing PF. METHODS: A total 71 patients who underwent a DP were enrolled...
July 2015: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
Laurent Poincloux, Olivier Rouquette, Emmanuel Buc, Jocelyn Privat, Denis Pezet, Michel Dapoigny, Gilles Bommelaer, Armando Abergel
BACKGROUND AND STUDY AIM: Endoscopic ultrasound (EUS)-guided biliary access is an alternative to percutaneous access after failed endoscopic retrograde cholangiopancreatography (ERCP). This report presents 7 years' cumulative experience of EUS-guided biliary drainage for obstructive jaundice in patients with failed ERCP. PATIENTS AND METHODS: Between February 2006 and February 2013, 101 patients (malignant = 98, benign = 3) with previous failed ERCP underwent an EUS intra- or extrahepatic approach with transluminal stenting or an EUS-guided rendezvous procedure with transpapillary stent placement...
September 2015: Endoscopy
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