当前位置： SCI文献检索 > AMERICAN JOURNAL OF SURGERY期刊下所有文献 > Role of octreotide in the prevention of postoperative complications following pancreatic resection.

Role of octreotide in the prevention of postoperative complications following pancreatic resection.

Abstract：

:Though morbidity and mortality rates following pancreatic resection have improved in recent years, they are still around 35% and 5%, respectively. Typical complications, such as pancreatic fistula, abscess, and subsequent sepsis, are chiefly associated with exocrine pancreatic secretion. In order to clarify whether the perioperative inhibition of exocrine pancreatic secretion prevents complications, we assessed the efficacy of octreotide, a long-acting somatostatin analogue. We conducted a randomized, double-blind, placebo-controlled, multicenter trial in 246 patients undergoing major elective pancreatic surgery. Patients were stratified into a high-risk stratum (limited to patients with pancreatic and periampullary tumors) or low-risk stratum (patients with chronic pancreatitis). Patients received octreotide (3 x 100 micrograms) or placebo subcutaneously for 7 days perioperatively. Eleven complications were defined: death, leakage of anastomosis, pancreatic fistula, abscess, fluid collection, shock, sepsis, bleeding, pulmonary insufficiency, renal insufficiency, and postoperative pancreatitis. Two hundred patients underwent pancreatic head resection, 31 patients underwent left resection, and 15 patients had other procedures. The overall mortality rate within 90 days was 4.5%, with 3.2% in the octreotide group and 5.8% in the placebo group. The complication rate was 32% in the patients receiving octreotide (40 of 125 patients) and 55% in patients receiving placebo (67 of 121 patients) (p less than 0.005). In the patients in the high-risk stratum, complications were observed in 26 of the 68 (38%) patients treated with octreotide and in 46 of 71 (65%) patients given placebo (p less than 0.01). Whereas in patients in the low-risk stratum, the complication rate was 25% (14 of 57 patients) in those treated with octreotide and 42% (21 of 50 patients) in patients given placebo (p = NS). The perioperative application of octreotide reduces the occurrence of typical postoperative complications after pancreatic resection, particularly in patients with tumors.

journal_name

Am J Surg

journal_title

American journal of surgery

authors

Büchler M,Friess H,Klempa I,Hermanek P,Sulkowski U,Becker H,Schafmayer A,Baca I,Lorenz D,Meister R

doi

10.1016/0002-9610(92)90264-r

subject

Has Abstract,Author List Incomplete

pub_date

1992-01-01 00:00:00

pages

125-30; discussion 130-1

issue

eissn

0002-9610

issn

1879-1883

pii

0002-9610(92)90264-R

journal_volume

163

pub_type

临床试验,杂志文章,多中心研究,随机对照试验

在线工具

Role of octreotide in the prevention of postoperative complications following pancreatic resection.