Octreotide Does Not Prevent Pancreatic Fistula Following Pancreatoduodenectomy in Patients with Soft Pancreas and Non-dilated Duct: A Prospective Randomized Controlled Trial.

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. Surgical steps were standardized and incidences of pancreatic fistula, complications, death and hospital stay were assessed.

RESULTS: There were 55 patients in octreotide group and 54 in the control group. Demographic features and pancreatic duct diameter of the groups were comparable. The rates of clinically significant pancreatic fistulae (grades B and C) were 10.9 and 18.5 % (p = ns), and morbidity was 18 and 29.6 % (p = ns), respectively. Patients who received octreotide resumed oral diet early and had a shorter hospital stay.

CONCLUSION: This study demonstrated no statistical difference in pancreatic fistulae with the use of octreotide, though there was a trend towards fewer incidences of pancreatic fistulae, morbidity and shorter hospital stay. ClinicalTrials.gov Identifier: NCT01301222.