Cochrane Summaries

Trusted evidence. Informed decisions. Better health.
Language:
English

Somatostatin analogues for reducing complications following pancreatic surgery

Gurusamy KS, Koti R, Fusai G, Davidson BR
Published Online: 
30 April 2013

Pancreatic resections are associated with high morbidity (30% to 60%) and mortality (5%). It is not clear whether routine, preventive use of synthetic analogues of somatostatin (a hormone that inhibits pancreatic secretions) could reduce complications following pancreatic surgery. We included 21 randomised clinical trials in this review. All trials had high risk of bias ('systematic error'). A total of 2348 people were randomised either to somatostatin analogues or a control in the 21 trials. The overall number of people with postoperative complications was lower by 30% in the somatostatin analogues group but there was no difference in postoperative mortality, re-operation rate or overall length of hospital stay between the groups. Pancreatic fistula is drainage of pancreatic juice secreted by the remaining pancreas to the exterior. This was lower in the intervention group by 34%. The proportion of these fistulas that resulted in change to the treatment given to the participants is not clear. When we included trials that clearly distinguished fistulas that required change to the treatment given to the participants, there was no difference between the two groups. Participant quality of life was not reported in any of the trials. In conclusion, somatostatin analogues reduce the incidence of pancreatic fistula. Further trials with sufficient participant numbers and a low risk of bias are necessary. Based on the current available evidence, somatostatin and its analogues are recommended for routine use in people undergoing pancreatic resection.