Document Detail


Somatostatin versus octreotide in the treatment of patients with gastrointestinal and pancreatic fistulas.
MedLine Citation:
PMID:  15152279     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: Gastrointestinal and pancreatic fistulas are characterized as serious complications following abdominal surgery, with a reported incidence of up to 27% and 46%, respectively. Fistula formation results in prolonged hospitalization, increased morbidity/mortality and increased treatment costs. Conservative and surgical approaches are both employed in the management of these fistulas. The purpose of the present study was to assess, evaluate and compare the potential clinical benefit and cost effectiveness of pharmacotherapy (somatostatin versus its analogue octreotide) versus conventional therapy.
PATIENTS AND METHODS: Fifty-one patients with gastrointestinal or pancreatic fistulas were randomized to three treatment groups: 19 patients received 6000 IU/day of somatostatin intravenously, 17 received 100 microg of octreotide three times daily subcutaneously and 15 patients received only standard medical treatment.
RESULTS: The fistula closure rate was 84% in the somatostatin group, 65% in the octreotide group and 27% in the control group. These differences were of statistical significance (P=0.007). Overall mortality rate was less than 5% and statistically significant differences in mortality among the three groups could not be established. Overall, treatment with somatostatin and octreotide was more cost effective than conventional therapy (control group), and somatostatin was more cost effective than octreotide. The average hospital stay was 21.6 days, 27.0 and 31.5 days for the somatostatin, octreotide and control groups, respectively.
CONCLUSIONS: Data suggest that pharmacotherapy reduces the costs involved in fistula management (by reducing hospitalization) and also offers increased spontaneous closure rate. Further prospective studies focusing on the above parameters are needed to demonstrate the clinicoeconomic benefits.
Authors:
Emanuel Leandros; Pantelis T Antonakis; Konstantinos Albanopoulos; Chris Dervenis; Manousos M Konstadoulakis
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Canadian journal of gastroenterology = Journal canadien de gastroenterologie     Volume:  18     ISSN:  0835-7900     ISO Abbreviation:  Can. J. Gastroenterol.     Publication Date:  2004 May 
Date Detail:
Created Date:  2004-05-20     Completed Date:  2004-09-02     Revised Date:  2014-01-17    
Medline Journal Info:
Nlm Unique ID:  8807867     Medline TA:  Can J Gastroenterol     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  303-6     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Abdomen / surgery
Aged
Costs and Cost Analysis
Female
Gastric Fistula / drug therapy*,  economics,  etiology
Gastrointestinal Agents / economics,  therapeutic use*
Humans
Intestinal Fistula / drug therapy*,  economics,  etiology
Length of Stay / economics
Male
Middle Aged
Octreotide / economics,  therapeutic use*
Pancreatic Fistula / drug therapy*,  economics,  etiology
Postoperative Complications
Somatostatin / economics,  therapeutic use*
Chemical
Reg. No./Substance:
0/Gastrointestinal Agents; 51110-01-1/Somatostatin; RWM8CCW8GP/Octreotide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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