Eficacia del octreótido en el tratamiento de la fístula quilosa asociada a enfermedades pancreáticas

Abstract

IntroductionA chyle fistula is an uncommon complication following abdominal and pancreatic surgery, particularly in the retroperitoneal compartment. It can also appear as a complication of a severe acute pancreatitis. Medical treatment is the initial approach, but resolution is often slow. Somatostatin or octreotide can help in accelerating the resolution of fistulae. Patients and methodsPatients developing a chyle fistula (output > 100ml/24h, normal amylase levels and triglyceride concentrations above 110mg/dl) associated with pancreatic disorders were treated with oral intake restriction and parenteral nutrition, followed by subcutaneous octreotide 0.1mg/8h. ResultsFour female patients from 55 to 80 years old, underwent pancreatic surgery or presented with an acute pancreatitis, were treated. Chyle fistulae ranging from 100 to 2,000ml/24h were treated with octreotide, being resolved within five to seven days. No recurrence has been found in a 2 to 4 years follow up. ConclusionsWe have found that chyle fistula medical treatment is often related to a slow resolution, somatostatin or octreotide administration dramatically reduces its duration. Other previously reported studies have also shown that the quick onset of such treatment can accelerate the whole process, leading to a shorter recovery and lower hospital costs.