ArticleHPB : the official journal of the International Hepato Pancreato Biliary Association2014
Prophylactic octreotide for pancreatoduodenectomy: more harm than good?
Article in HPB : the official journal of the International Hepato Pancreato Biliary Association, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 7 of them syntheses that pooled it.
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The trial behind it
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Who cites it
36 citing papers in PubMed, 7 syntheses or guidelines pooled it, 86 citations in OpenAlex.
- Early vs late drain removal after pancreatic resection-a systematic review and meta-analysis.Langenbeck's archives of surgery · 2023Pooled it
- Efficacy of Pasireotide for Prevention of Postoperative Pancreatic Fistula in Pancreatic Surgery: a Systematic Review and Meta-analysis.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2020Pooled it
- Pooled it
- The Use of Prophylactic Somatostatin Therapy Following Pancreaticoduodenectomy: A Meta-analysis of Randomised Controlled Trials.World journal of surgery · 2019Pooled it
- Risk factors and preventive strategies for post-operative pancreatic fistula after pancreatic surgery: a comprehensive review.Scandinavian journal of gastroenterology · 2016Pooled it
- Defining post-operative pancreatitis as a new pancreatic specific complication following pancreatic resection.HPB : the official journal of the International Hepato Pancreato Biliary Association · 2016Pooled it
- Calculating the risk of a pancreatic fistula after a pancreaticoduodenectomy: a systematic review.HPB : the official journal of the International Hepato Pancreato Biliary Association · 2015Pooled it
- Trial
- Randomized clinical trial of the effect of a fibrin sealant patch on pancreatic fistula formation after pancreatoduodenectomy.The British journal of surgery · 2018Trial
- Octreotide Does Not Prevent Pancreatic Fistula Following Pancreatoduodenectomy in Patients with Soft Pancreas and Non-dilated Duct: A Prospective Randomized Controlled Trial.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2015Trial
- Pancreatic ductal adenocarcinoma and pancreatic surgery in the 21st century: triumphs, turning points, and unresolved challenges.Updates in surgery · 2026Review
- Construction of a predictive model for postoperative pancreatic fistula following pancreaticoduodenectomy and an exploration of inflammatory biomarker associations.Gland surgery · 2026Article
- Somatostatin Analogs for Preventing Postoperative Pancreatic Fistula: Past Evidence Reveals New Opportunities.Annals of surgical oncology · 2025Review
- Review
- Non-Surgical Interventions for the Prevention of Clinically Relevant Postoperative Pancreatic Fistula-A Narrative Review.Cancers · 2023Review
- Effect of postoperative utilization of somatostatin on clinical outcome after definitive surgery for duodenal fistula.European journal of medical research · 2023Article
- Development and external validation of DISPAIR fistula risk score for clinically relevant postoperative pancreatic fistula risk after distal pancreatectomy.The British journal of surgery · 2022Article
- Risk Factors and Clinical Impacts of Post-Pancreatectomy Acute Pancreatitis After Pancreaticoduodenectomy: A Single-Center Retrospective Analysis of 298 Patients Based on the ISGPS Definition and Grading System.Frontiers in surgery · 2022Article
- SSAT GI Surgery Debate: Hepatobiliary and Pancreas: Is Post-Pancreatectomy Acute Pancreatitis a Relevant Clinical Entity?Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2022Article
- Central Pancreatectomy: Significance of Vascularity on Anastomotic Integrity and a Note on Reconstructive Technique.Cureus · 2021Article
Corrections and comments
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Authors and funding
9 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMost accrued evidence regarding prophylactic octreotide for a pancreatoduodenectomy (PD) predates the advent of the International Study Group of Pancreatic Fistula (ISGPF) classification system for a post-operative pancreatic fistula (POPF), and its efficacy in the setting of high POPF risk is unknown. The Fistula Risk Score (FRS) predicts the risk and impact of a clinically relevant (CR)-POPF and can be useful in assessing the impact of octreotide in scenarios of risk.
methodsFrom 2001-2013, 1018 PDs were performed at four institutions, with octreotide administered at the surgeon's discretion. The FRS was used to analyse the occurrence and burden of POPF across various risk scenarios.
resultsOverall, 391 patients (38.4%) received octreotide. A CR-POPF occurred more often when octreotide was used (21.0% versus 7.0%; P < 0.001), especially when there was advanced FRS risk. Octreotide administration also correlated with an increased hospital stay (mean: 13 versus 11 days; P < 0.001). Regression analysis, controlling for FRS risk, demonstrated that octreotide increases the risk for CR-POPF development.
conclusionThis multi-institutional study, using ISGPF criteria, evaluates POPF development across the entire risk spectrum. Octreotide appears to confer no benefit in preventing a CR-POPF, and may even potentiate CR-POPF development in the presence of risk factors. This analysis suggests octreotide should not be utilized as a POPF mitigation strategy.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.