A Case Report of the Effect of a Somatostatin Analogue in the Management of Postoperative Pancreatic Fistula

Koji Fujimoto, Satoaki Sakai, Satoru Matsusue, Hiroshi Takeda

Department of Abdominal Surgery, Tenri Hospital

A 58-year-old man was diagnosed to have dermatomyositis nine years ago and steroid therapy was begun. Duodenoscopy revealed a tumor at the papilla of Vater two years later. He has been observed because histopathological examination showed only adenoma. Recently, however, the tumor changed to adenocarcinoma on histopathological examination. Moreover, positive occult blood of stool lead to colonoscopy, which revealed rectal cancer. Although the patient has been on high dose steroid therapy, pancreaticoduodenectomy with end-to-side pancreaticojejunostomy and anterior resection of the rectum had to be performed. A pancreatic fistula developed after the operation. The daily output of the fistula reached 600 ml. Sandostatin^® was administered at a dose of 100 µg twice a daily subcutaneously, and spontaneous closure of the fistula occurred after one week. This case in illustrative of the effectiveness of in the management of postoperative pancreatic fistula.

Key words
pancreatic fistula, somatostain analogue

Reprint requests
Koji Fujimoto Department of Abdominal Surgery, Tenri Hospital
200 Mishima-cho, Tenri, 632 JAPAN

Accepted
June 8, 1994

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