Complications and impact on the secretion of digestive juice of octreotide acetate prophylactic application of head of pancreas after pancreaticoduodenectomy

Abstract

Objective To investigate the preventive application of octreotide acetate for the prevention of complications and serum pancreatic amylase secrection after pancreatoduodenectomy(PD).Methods Fiftysix cases who underwent PD in our hospital were randomized into the observational group (n =28) and the control group (n =28).The control group received routine preoperative treatment including fasting,gastrointestinal decompression,nutritional support,maintenance of water,electrolyte balance and the use of antibiotics,postoperative routine parenteral nutrition and antibiotic therapy.In addition to the conventional treatment,the observational group received prophylactic application of octreotide acetate by subcutaneous injection of 0.1 mg each time,3 times a day,and 7 days for a cycle of treatment.Blood biochemical index and postoperative complications in the two groups were monitored.Results The serum amylase levels in the observational group and the control group were (304.63 ±62.21) U/L and (445.52 ±64.52) U/L respectively at the tenth day after treatment.The two groups are significantly different in the serum amylase level (t =2.243,P ＜ 0.05).The pancreatic juice,gastric juice and bile drainage of patients in the observational group and the control group were (46.83 ± 31.42) ml,(189.92 ± 59.64) ml,(178.94 ± 45.18) ml,and (69.84 ± 34.30)ml,(237.08 ±71.27) ml,(356.11 ±64.23) ml respectively.The observational group had significantly reduced digestive fluid drainage volume compared with the control group (t =3.219,2.276,4.618 respectively,P ＜0.05).Complications occurred in 3 patients of the observational group (including 1 case of pancreatic fistula,1 case of hemorrhage,and 1 case of gastric emptying delay),with an incidence of 10.71％ (3/28).Complications occurred in 12 cases of the control group (including 3 cases of pancreatic fistula,2 cases of hemorrhage,3 cases of bile leakage,2 cases of delayed gastric emptying,2 cases of peritoneal infection),with an incidence of 42.86％ (12/28).There was significant difference between two groups in the incidence of complications (x2 =4.293,P ＜ 0.05).Conclusion Prophylactic application of somatostatin in PD restrains the secretion of digestive juice,and plays a preventive role for postoperative complications.The routine prophylactic application of octreotide in PD is necessary. Key words: Octreotide; Pancreatoduodenectomy; Amylopsin; Complications