The effect of somatostatin analogues on postoperative outcomes following pancreatic surgery: A meta-analysis.

Published on Dec 6, 2017in PLOS ONE2.776
· DOI :10.1371/journal.pone.0188928
Xianlin Han4
Estimated H-index: 4
Zhiyan Xu1
Estimated H-index: 1
+ 2 AuthorsWenming Wu10
Estimated H-index: 10
BACKGROUND: Leakage from the pancreatic stump is a leading cause of morbidity following pancreatic surgery. It is essential to evaluate the effect of somatostatin analogues (SAs) following pancreatic surgery by analyzing all recent clinical trials. DATA SOURCES: We performed a literature search in the Medline, EMBASE, Cochrane Central Register of Controlled Trials and Web of Science databases up to May 29, 2016. Publication bias was assessed with Egger's test. Study quality was assessed using the Jadad Composite Scale. CONCLUSIONS: Twelve clinical trials involving 1703 patients from Jan 1st, 2000 to May 29th, 2016 were included in the study. With improvements in surgical management and peri-operative patient care, prophylactic use of somatostatin and its analogues reduced the overall incidence of pancreatic fistulas (RR 0.72, 95% CI 0.55-0.94; p = 0.02) and decreased the post-operative hospital stay after pancreatic surgery (the weighted mean difference was -1.06, 95% CI-1/88 to -0.23; p = 0.01). Other post-operative outcomes did not change significantly with the use of somatostatin analogues.
  • References (37)
  • Citations (2)
#1Jashodeep Datta (UPenn: University of Pennsylvania)H-Index: 16
#2Charles M. Vollmer (UPenn: University of Pennsylvania)H-Index: 30
The surgical management of pancreatic diseases is rapidly evolving, encompassing advances in evidence-driven selection of patients amenable for surgical therapy, preoperative risk stratification, refinements in the technical conduct of pancreatic operations, and quantification of postoperative morbidity. These advances have resulted in dramatic reductions in mortality following pancreatic surgery, particularly at high-volume pancreatic centers. Surgical decision making is complex, and requires a...
5 CitationsSource
#1Prakash Kurumboor (Memorial Hospital of South Bend)H-Index: 3
#2Kamalesh Nadothottam Palaniswami (Memorial Hospital of South Bend)H-Index: 1
Last. Sylesh Aikot (Memorial Hospital of South Bend)H-Index: 1
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Background Whether octreotide prevents pancreatic fistula following pancreatoduodenectomy is controversial and it is believed to be beneficial in soft glands and normal-sized ducts. The aim of this study is to assess the potential value of octreotide in reducing the incidence of pancreatic fistula, postoperative complications, morbidity and hospital stay in patients with soft pancreas and non-dilated ducts.
18 CitationsSource
#1Kai-Zhou JinH-Index: 4
#2Haiyang ZhouH-Index: 5
Last. Yi WangH-Index: 8
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Background: The use of somatostatin analogues (SAs) following pancreaticoduodenectomy (PD) is controversial. Method: Literat
19 CitationsSource
#1Ryan James Anderson (University of Louisville)H-Index: 3
#2Erik M. Dunki-Jacobs (University of Louisville)H-Index: 7
Last. Robert C.G. Martin (University of Louisville)H-Index: 61
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Background Studies have shown that somatostatin reduces the occurrence of postoperative pancreatic fistula. However, no study to date has analyzed the cost effectiveness of this treatment. The purpose of this study was to analyze the cost effectiveness of prophylactic somatostatin use with respect to pancreatectomy.
6 CitationsSource
#1Panagiotis Drymousis (Imperial College London)H-Index: 7
#2Madhava Pai (Imperial College London)H-Index: 18
Last. Emmanouil Zacharakis (Imperial College London)H-Index: 20
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Abstract A best evidence topic was written according to a structured protocol. The question addressed was whether the prophylactic administration of somatostatin or somatostatin analogues in patients undergoing pancreaticoduodenectomy (Whipple's procedure) is beneficial in terms of improved surgical outcomes, reduced morbidity or reduced mortality. A total of 118 papers were found using the reported searches of which 5 represented the best evidence (1 meta-analysis, 1 systematic review and 3 ran...
7 CitationsSource
Last. Joana FerrerH-Index: 19
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Background Octreotide is generally administered based on the surgeon's interpretation of perceived risk for pancreatic fistula at the time of pancreaticoduodenectomy (PD). Methods A single-institution, prospective randomized trial was conducted between April 2009 and December 2011 involving 62 PD patients who were randomized to receive octreotide (100 μg subcutaneously every 8 h; n = 32) or placebo (n = 30). Pancreatic juice output was measured after the operation using a catheter inserted into ...
27 CitationsSource
#1R. F. de WildeH-Index: 1
#2Marc G. BesselinkH-Index: 53
Last. Quintus MolenaarH-Index: 29
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Background: The impact of nationwide centralization of pancreaticoduodenectomy (PD) on mortality is largely unknown. The aim of this study was to analyse changes in hospital volumes and in-hospital mortality after PD in the Netherlands between 2004 and 2009. Methods: Nationwide data on International Classification of Diseases, ninth revision (ICD-9) code 5-526 (PD, including Whipple), patient age, sex and mortality were retrieved from the independent nationwide KiwaPrismant registry. Based on es...
153 CitationsSource
Background: Somatostatin has been found to be effective in the prevention of postoperative complications in pancreatic surgery. It can inhibit the pancreatic secretions that, quite often, are responsible for complications during the postoperative period.
4 CitationsSource
#1Rahul S. Koti (Royal Free Hospital)H-Index: 16
#2Kurinchi Selvan Gurusamy (Royal Free Hospital)H-Index: 47
Last. Brian R. Davidson (Royal Free Hospital)H-Index: 44
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Abstract Background The use of synthetic analogues of somatostatin following pancreatic surgery is controversial. The aim of this meta-analysis is to determine whether prophylactic somatostatin analogues (SAs) should be used routinely in pancreatic surgery. Methods Randomized controlled trials were identified from the Cochrane Library Trials Register, MEDLINE, EMBASE, Science Citation Index Expanded and reference lists. Data were extracted from these trials by two independent reviewers. The risk...
71 CitationsSource
#1Otto KollmarH-Index: 25
#2M. R. MoussavianH-Index: 12
Last. Martin K. SchillingH-Index: 41
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AIMS: To evaluate the impact of prophylactic octreotide on gastric emptying in patients undergoing pancreaticoduodenectomy. Postoperative pancreatic fistula (POPF) and delayed gastric emptying (DGE) are common complications after pancreaticoduodenectomy. Whereas several prospective randomized trials propose the prophylactic use of octreotide to prevent pancreatic fistula formation, somatostatin has, however, been associated with delayed gastric emptying after partial duodenopancreatectomy. METHO...
59 CitationsSource
Cited By2
#1A. P. Koshel (Siberian State Medical University)H-Index: 1
#2E. S. Drozdov (Siberian State Medical University)
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#1Tianpei Li (NUS: National University of Singapore)
#1Li Tianpei (NUS: National University of Singapore)
Last. Vishal G. Shelat (TTSH: Tan Tock Seng Hospital)H-Index: 15
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Abstract Background Post-operative pancreatic fistula (POPF) is a common complication of pancreatic resection. Somatostatin analogues (SA) have been used as prophylaxis to reduce its incidence. The aim of this study is to appraise the current literature on the effects of SA prophylaxis on the prevention of POPF following pancreatic resection. Methods The review of the literature was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data f...
#1Stephan Schorn (TUM: Technische Universität München)H-Index: 9
#2Ihsan Ekin Demir (TUM: Technische Universität München)H-Index: 29
Last. Güralp O. Ceyhan (TUM: Technische Universität München)H-Index: 32
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Background Pancreaticoduodenectomy/PD is a technically demanding pancreatic resection. Options of surgical reconstruction include (1) the child reconstruction defined as pancreatojejunostomy/PJ followed by hepaticojejunostomy/HJ and the gastrojejunostomy/GJ “the standard/s-Child,” (2) the s-child reconstruction with an additional Braun enteroenterostomy “BE-Child,” or (3) Isolated-Roux-En-Y-pancreaticojejunostomy “Iso-Roux-En-Y,” in which the pancreas anastomosis is reconstructed in a separate l...
#1A. Adiamah (NUH: Nottingham University Hospitals NHS Trust)H-Index: 1
#2Z. Arif (NUH: Nottingham University Hospitals NHS Trust)H-Index: 1
Last. Dhanny Gomez (NUH: Nottingham University Hospitals NHS Trust)H-Index: 7
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Background Prophylactic administration of somatostatin analogues (SA) to reduce the incidence of post-operative pancreatic fistula (POPF) remains contentious. This meta-analysis evaluated its impact on outcomes following pancreaticoduodenectomy (PD).
1 CitationsSource