Octreotide for treatment of postoperative alimentary tract fistulas

Haim Paran*, David Neufeld, Ofer Kaplan, Joseph Klausner, Uri Freund

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Eighteen patients with postoperative fistulas of the gastrointestinal tract were treated with the somatostatin analog octreotide between November 1989 and November 1992. Fourteen patients had enterocutaneous fistulas: seven from the duodenum and seven from the ileum. Another three patients had pancreatic fistulas, and one patient had a biliary fistula. Within 24 hours of octreotide treatment, a mean reduction of 52% in the intestinal fistulas' output, 40% in the pancreatic fistulas, and 30% in the biliary fistula was noted. In the intestinal fistulas group the closure rate was 72% after a mean of 11 days. Early closure (mean 6 days) was achieved in all three pancreatic fistulas. In the patient with the biliary fistula a 30% reduction was observed twice following the administration of octreotide, and an increase occurred when it was withheld. The reduction rate of the secretions in high-output intestinal fistulas (>500 ml/day) was higher than in the low-output fistulas (63±8% versus 39±4%, p<0.05). Fistula output and the initial response to octreotide treatment had no value in predicting spontaneous healing. In conclusion, octreotide is a valuable tool for the conservative treatment of fistulas of the digestive tract. It is especially valuable for management of high-output enteric fistulas and pancreatic fistulas.

Original languageEnglish
Pages (from-to)430-433
Number of pages4
JournalWorld Journal of Surgery
Volume19
Issue number3
DOIs
StatePublished - May 1995

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