Report of a Case in Whom Somatostatin Analogue Had Good Effects in Pancreatic Distula after Pancreatojejunal Anastomosis of Pancreatoduodenectomy

Michihiko Kogure, Shinya Terashima, Osamu Konno, Yoshinao Takano, Masamitsu Ogata, Yasushi Teranishi, Hitoshi Inoue, Ryoichi Motoki

First Department of Surgery, Fukushima Medical College

We found that Somatostatin Analogue (SMS 201-995) is very effective in reducing small bowel fistula output. A patient received pancreatoduodenectomy for cancer of the lower common bile duct and had a leak at the pancreatojejunostomy. He had been on conservative treatment with hyperalimentation (40 Kcal/kg) for 15 weeks, but had an enterocutaneous fistula with 400 ml output per day. Then we subcutaneously administered SMS 201-995 at a dose of 100 μg/8 hours for 14 days. Within 24 hours of treatment, a 50% reduction of the fistula output was observed. Fistula output stopped on the 8th days after starting the treatment with SMS 201-995 and then the fistula closed spontaneously. Glucagon and C-peptide secretin were slightly inhibited, and secretin secretion was moderately inhibited, but glucose intolearance and inhibition of other intestinal secretions glutamic pyruvic transaminase levels increased to l25 IU/L and 110 IU/L respectively, but immediately returned to the normal range. No other side effects attribugtable to the drugs were observed. We found that SMS 201-995 could be safly and effectively used for pancrea to jejunal fistula.

Key words
somatostatin analogue (SMS 201-995), pancreatojejunal fistula

Reprint requests
Michihiko Kogure The First Department of Surgery, Fukushima Medical College
1 Hikarigaoka, Fukushima-shi, 960-12 JAPAN

Accepted
June 17, 1992

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