Treatment of external biliary, pancreatic and intestinal fistulas with a somatostatin analog.

Somatostatin and its long-acting analog octreotide (SMS 201-995) inhibit several gastrointestinal functions. Their effects have been studied in the treatment of small numbers of external pancreatic, intestinal and biliary fistulas. We treated 8 biliary, 4 pancreatic and 5 intestinal cutaneous fistulas with octreotide. Mean decreases in fistula output before octreotide treatment were not significant (p > 0.01 for each group). On the 1st day of octreotide treatment, mean fistula output decreased from 412 +/- 60.4 to 234 +/- 57.7 ml in the biliary, from 457.5 +/- 57.5 to 217.5 +/- 11.8 ml in the pancreatic and from 564 +/- 49.2 to 217.5 +/- 11.8 ml in the enterocutaneous fistula groups (p < 0.01 for each). No serious side effects were recorded. We conclude that octreotide is an important adjunct in the conservative treatment of external biliary, pancreatic and intestinal fistulas, by decreasing their output.