Sandostatin for pancreatic fistulas
Among the reffects of Snadostatin is reduction of blood flow to the Go tract, and inhibition of release of several gastrointestinal hormones, which might decrease leaking from fistulas after surgery and help them heal. Several studies and a meta-analysis looked at this effect. UNfortunately, the results are mixed and not entirely convincing.
A recent Cochrane review of somatostatin analogues (SSAs) for pancreatic surgery concluded that SSAs reduce perioperative complications but do not reduce perioperative mortality. They do shorten hospital stay. Based on the current available evidence, somatostatin and its analogues are recommended for routine use in patients undergoing pancreatic resection for malignancy. There is currently no evidence to support their routine use in pancreatic surgeries performed for other indications.
In a meta-analysis by Zeng et al., the conclusion was that the use of somatostatin and its analogues does not significantly reduce postoperative complications after pancreaticoduodenectomy.
A recent review on surgicalcriticalcare.net concluded that : “There is insufficient evidence to conclude that octreotide reduces fistula closure rates or time to closure. Octreotide therapy
may be useful when there is reason to believe that a reduction in fistula output would facilitate patient management. However, its use for the purpose of fistula closure or the use of doses greater than those evaluated in clinical trails cannot be recommended.”
For professional version see here