Long-term results of octreotide-therapy in severe dumping syndrome.

Abstract

Little is known about the long-term results of octreotide therapy in dumping syndrome. We report the results of an open study including 20 patients with severe dumping symptoms after gastric surgery treated with octreotide between 1987 and 1997 at the Leiden University Medical Centre. Patient selection was based on (1) the results of a dumping provocation test and (2) symptoms that were refractory to other therapeutic measures. At regular intervals the presence of dumping symptoms was evaluated together with measurement of body weight and faecal fat excretion. Mean follow-up was 37 +/- 9 months (range 1-107 months). Doses of octreotide ranged from 25 to 200 microg/day. Initial relief of symptoms was achieved in all subjects, but after three months of therapy symptom relief persisted in 80% of patients. Mean body weight increased by 2.4 +/- 1.2 kg despite a significant increase in faecal fat excretion from 10 +/- 2 g/24 h to 24 +/- 3 g/24 h. Reasons for discontinuation of therapy were diminished efficacy in the longer term in 4 patients and side-effects in 7 patients. Biliary complications were encountered in 3 patients. Self-administration of octreotide proves an effective symptomatic treatment of severe dumping, even on the long-term. Its use is frequently limited by the occurrence of side-effects.