Impact of pasireotide on postoperative pancreatic fistulas following distal resections.
Pancreatic distal resection
Pancreatic fistula
Pancreatic surgery
Postoperative complications
Journal
Langenbeck's archives of surgery
ISSN: 1435-2451
Titre abrégé: Langenbecks Arch Surg
Pays: Germany
ID NLM: 9808285
Informations de publication
Date de publication:
May 2021
May 2021
Historique:
received:
11
06
2020
accepted:
07
01
2021
pubmed:
22
1
2021
medline:
25
9
2021
entrez:
21
1
2021
Statut:
ppublish
Résumé
Postoperative pancreatic fistula (POPF), a difficult complication after surgery, can cause peripancreatic fluid collection and infections in the operative area. In addition, pancreatic fluid is corrosive and can lead to postoperative bleeding. Clinically significant grade B and C fistulas (CR-POPF) increase postoperative morbidity, resulting in a prolonged hospital stay. Delaying adjuvant therapy due to fistula formation in cancer patients can affect their prognosis. In this study, we aimed to determine if pasireotide affects fistula formation, and the severity of other complications in patients following pancreatic distal resections. Between 2000 and 2016, 258 distal pancreatectomies were performed at Helsinki University Hospital and were included in our analysis. Pasireotide was administered to patients undergoing distal resections between July 2014 and December 2016. Patients received 900-μg pasireotide administered twice daily perioperatively. Other patients who received octreotide treatment were analyzed separately. Complications such as fistulas (POPF), delayed gastric emptying (DGE), postpancreatectomy hemorrhage (PPH), reoperations, and mortality were recorded and analyzed 90 days postoperatively. Overall, 47 (18%) patients received pasireotide and 31 (12%) octreotide, while 180 patients (70%) who received neither constituted the control group. There were 40 (16%) clinically relevant grade B and C POPFs: seven (15%) in the pasireotide group, three (10%) in the octreotide group, and 30 (17%) in the control group (p = 0.739). Severe complications categorized as Clavien-Dindo grade III or IV were recorded in 64 (25%) patients: 17 (27%) in the pasireotide group, 4 (6%) in the octreotide group, and 43 (67%) in the control group (p = 0.059). We found no 90-day mortality. In this study, pasireotide did not reduce clinically relevant POPFs or severe complications following pancreatic distal resection.
Identifiants
pubmed: 33474568
doi: 10.1007/s00423-021-02083-2
pii: 10.1007/s00423-021-02083-2
pmc: PMC8106579
doi:
Substances chimiques
Somatostatin
51110-01-1
pasireotide
98H1T17066
Octreotide
RWM8CCW8GP
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
735-742Références
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