Somatostatin analogues for the prevention of pancreatic fistula after open pancreatoduodenectomy: A nationwide analysis

• DOI: 10.1016/j.pan.2022.03.006
• Publication Date: 2022-03-10T07:38:59Z
• Authors: Boukje T. Bootsma; Victor D. Plat; Tim van de Brug; Daitlin E. Huisman; M. Botti; Peter B. van den ...; Bert A. Bonsing; Koop Bosscha; Cornelis H.C. Dejong; Bas Groot-Koerkamp; Jeroen Hagendoorn; Erwin van der Harst; Ignace H. de Hingh; Vincent E. de Meijer; Misha D. Luyer; Vincent B. Nieuwe...; Bobby K. Pranger; Hjalmar C. van Sa...; Jan H. Wijsman; Barbara M. Zonder...; Geert Kazemier; Marc G. Besselink; Freek Daams
• Keywords: Lanreotide; Pancreatic fistula; Pasireotide

Somatostatin analogues (SA) are currently used to prevent postoperative pancreatic fistula (POPF) development. However, its use is controversial. This study investigated the effect of different SA protocols on incidence POPF after pancreatoduodenectomy in a nationwide population.All patients undergoing elective open were included from Dutch Pancreatic Cancer Audit (2014-2017). Patients divided into six groups: no SA, octreotide, lanreotide, pasireotide, octreotide only high-risk (HR) and lanreotide HR patients. Primary endpoint was grade B/C. The updated alternative Fistula Risk Score compare rates across various risk scenarios.1992 included. Overall rate 13.1%. Lanreotide (10.0%), octreotide-HR (9.4%) protocol (12.7%) lower compared other (varying 15.1 19.1%, p = 0.001) crude analysis. Sub-analysis with showed significantly when treated (10.0%) protocol, pasireotide (21.6-26.9%, 0.006). Octreotide-HR lanreotide-HR comparable however not protocols. Multivariable regression analysis demonstrated be positively associated low odds-ratio (OR) for (OR 0.387, 95% CI 0.180-0.834, 0.015). In-hospital mortality affected.Use all has potential protective Protocols might favorable too. future studies warranted confirm these findings.