The effect of octreotide on fasting and postprandial splanchnic hemodynamics in cirrhosis

Abstract

The effect of octreotide on splanchnic hemodynamics was examined in cirrhotic patients both in the fasting and postprandial states using echo-Doppler flowmetry. The splanchnic parameters examined were portal venous blood flow (PVBF), superior mesenteric venous blood flow (SMVBF), and splenic venous blood flow (SPBF). In the fasting state, nine cirrhotic patients were examined at baseline and at 30 and 60min after octreotide administration. In the postprandial state, 16 cirrhotic patients were investigated in a prospective, placebo-controlled, crossover study. Data were collected at baseline, 30min after a standard liquid meal and at 30 and 60min after octreotide or placebo administration. In the fasting state, octreotide induced a mild reduction both in PVBF (-16%) and SMVBF (-12%). In contrast, in the postprandial state, octreotide induced a significantly larger decrease in PVBF (-32%) and SMVBF (-32%). SPBF showed no significant changes in either the fasting or postprandial state. Octreotide suppressed the release of glucagon, and in the postprandial state, changes in SMVBF significantly correlated with changes in glucagon after octreotide administration. We conclude that octreotide significantly reduces PVBF and SMVBF in the postprandial state, but has comparatively little effect in the fasting state, and may act via suppression of glucagon.