BACKGROUND: The use of somatostatin analogues (SAs) following pancreaticoduodenectomy (PD) is controversial. METHOD: Literature databases were searched systematically for relevant articles. A meta-analysis of all randomized controlled trials (RCTs) evaluating prophylactic SAs in PD was performed. RESULTS: Fifteen RCTs involving 1,352 patients were included. There was a towards reduced incidences of pancreatic fistulas (p = 0.26), clinically significant pancreatic fistulas (p = 0.08), and bleeding (p = 0.05) in prophylactic SAs group. In subgroup analyses, prophylactic somatostatin significantly reduced the incidence of pancreatic fistulas(p = 0.02), with a nonsignificant trend toward reduced incidence of clinically significantly pancreatic fistulas (p = 0.06).Pasireotide significantly reduced the incidence of clinically significantly pancreatic fistulas (p = 0.03). Octreotide had no influence on the incidence of pancreatic fistulas. CONCLUSION: The current best evidence suggests prophylactic treatment with somatostatin or pasireotide has a potential role in reducing the incidence of pancreatic fistulas, while octreotide had no influence on the incidence of pancreatic fistulas.High-quality RCTs assessing the role of somatostatin and pasireotide are required for further verification.
BACKGROUND: The use of somatostatin analogues (SAs) following pancreaticoduodenectomy (PD) is controversial. METHOD: Literature databases were searched systematically for relevant articles. A meta-analysis of all randomized controlled trials (RCTs) evaluating prophylactic SAs in PD was performed. RESULTS: Fifteen RCTs involving 1,352 patients were included. There was a towards reduced incidences of pancreatic fistulas (p = 0.26), clinically significant pancreatic fistulas (p = 0.08), and bleeding (p = 0.05) in prophylactic SAs group. In subgroup analyses, prophylactic somatostatin significantly reduced the incidence of pancreatic fistulas(p = 0.02), with a nonsignificant trend toward reduced incidence of clinically significantly pancreatic fistulas (p = 0.06).Pasireotide significantly reduced the incidence of clinically significantly pancreatic fistulas (p = 0.03). Octreotide had no influence on the incidence of pancreatic fistulas. CONCLUSION: The current best evidence suggests prophylactic treatment with somatostatin or pasireotide has a potential role in reducing the incidence of pancreatic fistulas, while octreotide had no influence on the incidence of pancreatic fistulas.High-quality RCTs assessing the role of somatostatin and pasireotide are required for further verification.
Authors: James R Howe; Nipun B Merchant; Claudius Conrad; Xavier M Keutgen; Julie Hallet; Jeffrey A Drebin; Rebecca M Minter; Terry C Lairmore; Jennifer F Tseng; Herbert J Zeh; Steven K Libutti; Gagandeep Singh; Jeffrey E Lee; Thomas A Hope; Michelle K Kim; Yusuf Menda; Thorvardur R Halfdanarson; Jennifer A Chan; Rodney F Pommier Journal: Pancreas Date: 2020-01 Impact factor: 3.327
Authors: Andreas Volk; Philipp Nitschke; Franziska Johnscher; Nuh Rahbari; Thilo Welsch; Christoph Reißfelder; Jürgen Weitz; Marius Distler; Soeren Torge Mees Journal: Langenbecks Arch Surg Date: 2016-09-15 Impact factor: 3.445
Authors: Linda W Ma; Ismael Dominguez-Rosado; Renee L Gennarelli; Peter B Bach; Mithat Gonen; Michael I D'Angelica; Ronald P DeMatteo; T Peter Kingham; Murray F Brennan; William R Jarnagin; Peter J Allen Journal: Ann Surg Date: 2017-01 Impact factor: 12.969
Authors: Suman B Koganti; Ravikanth Kongara; Sateesh Boddepalli; Naushad Shaik Mohammad; Venumadhav Thumma; Bheerappa Nagari; R A Sastry Journal: Ann Med Surg (Lond) Date: 2016-08-09