Octreotide in the Treatment of Pancreatic Pseudocysts

Abstract

Objective: To describe the potential use of octreotide in the treatment of pancreatic pseudocysts through a brief review of anecdotal case reports. Case Summary: Octreotide has been used in a few patients to effectively inhibit pancreatic secretions and shrink the size of persistently draining pseudocysts. The dosage of octreotide is 100–200 μg bid or tid sc, for up to 36 days or until resolution of the pseudocysts is achieved. Discussion: Persistent pancreatic pseudocysts of varying size and duration have been successfully treated with the use of octreotide. Larger pseudocysts, which are unlikely to resolve spontaneously, may remain unresolved with the use of octreotide and may still require conventional surgical intervention. The use of octreotide in such cases, however, may still be beneficial. Shrinkage of the pseudocysts, even without complete resolution, may result in reduction of pain and may prevent other complications that often accompany the unresolved pseudocysts. Conclusions: Anecdotal reports suggest that octreotide may be useful as a noninvasive alternative or adjunct to traditional surgical treatment of pancreatic pseudocysts. Further research with well-designed studies involving randomized comparative controls are necessary to correlate the degree of pseudocyst shrinkage with the dosage and duration of octreotide therapy. The apparent effectiveness of octreotide in reducing the size of persistent pancreatic pseudocysts and providing pain relief suggests that it may be a useful adjunct to surgical interventions. With smaller persistent pseudocysts, octreotide may be a treatment alternative to surgery.