Short-term administration of SMS 201-995 in the management of an external pancreatic fistula.

A patient presented to the hospital with a persistent high-output (greater than 250 ml/day) external pancreatic fistula after an enucleation of an insulinoma 5 months earlier. Daily treatment with SMS 201-995, a long-acting somatostatin analogue, for 8 days decreased fistulous output to less than 5 ml/day. The patient was discharged in stable condition 9 days after admission. All drainage ceased 2 days later, and the fistula has remained closed. SMS 201-995 has been shown to be effective in decreasing fistulous output of external pancreatic fistulas of various origins. With its few side effects and remarkable effectiveness, SMS 201-995 should be considered in the conservative management of any external pancreatic fistula.