trauma-list Digest, Vol 48, Issue 28

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--- You wrote:
1. Any role for octreotide now?  Should i have started octreotide early
on, when I first suspected the pancreatitis/pancreatic injury?
--- end of quote ---

I would agree with the other discussants that it is hard to find literature that definitively proves that Octreotide does anything to either prevent or definitively treat a pancreatic fistula.

However, I do approximately 30 elective pancreatic resections /year and the trauma / consult service I work on takes care of all the necrotizing pancreatitis /multiple debridements patients as well. My experience is similar, in that several cases where we have used Octreotide we have seen clear reductions in the fistula output and subsequent closure. Since it is expensive, the good thing is you can tell within 2-3 days if it is going to help. In those cases where it seems to assist closure, the output will go down dramatically in the first few days. So we will use it, but if it doesn't seem to effect the output we will also stop it within 3-4 days.

As Ron G. likes to say ...just my two cents.

John Sutton

John E. Sutton, Jr., M.D. , F.A.C.S
Professor of Surgery,  Dartmouth Medical School
Division Chief, Trauma and Acute Surgical Care
phone: 603-650-8022
fax :     603-650-8030

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