Abstract:
Objective To evaluate whether the prophylactic use of octreotide after laparoscopic pancreaticoduodenectomy (LPD) can reduce the incidence of postoperative pancreatic fistula (POPF) formation and other complications.
Methods The perioperative data of 96 patients who underwent LPD in The Affiliated Hospital of Xuzhou Medical University from September 26, 2018, to May 12, 2020, were collected; patients were assigned into an octreotide group (47 cases) and a control group (49 cases). The incidence of POPF formation (biochemical fistula, fistula grade B or C) and other complications, as well as the postoperative duration of mechanical ventilation, length of hospital stay, and nutritional status were compared between the two groups.
Results In the octreotide group, there were ten cases of biochemical fistula, six cases of grade B fistula, and no cases of grade C fistula. In the control group, there were nine cases of biochemical fistula, five cases of grade B fistula, and one case of grade C fistula. The incidence of POPF formation in the two groups (octreotide vs. control) was as follows: biochemical fistula, 21.3% vs. 18.4%; grade B fistula, 12.8% vs. 10.2%; and grade C fistula, 0 vs. 2.0%. There were no significant differences between the two groups (P>0.05). On the postoperative day 7, the nutritional indices, namely the total protein, albumin and prealbumin levels, in the octreotide group were significantly better than those in control group total protein: (65.71±4.03) g/L vs. (63.53±5.53) g/L, P=0.030; albumin: (41.42±3.41) g/L vs. (39.75±3.92) g/L, P=0.029; prealbumin: (0.16±0.05) g/L vs. (0.14±0.04) g/L, P=0.033. The duration of mechanical ventilation in the octreotide group was significantly shorter than that in the control group (3.9±1.4) vs. (4.5±1.0) days; P=0.013. The postoperative length of hospital stay in the octreotide group was also significantly shorter than that in the control group (12.7±3.9) vs. (14.7±5.4) days; P=0.042.
Conclusions In the current study, prophylactic use of octreotide was not able to reduce the incidence of POPF formation. Nonetheless, patients in the octreotide group required mechanical ventilation for a shorter duration, recovered earlier, and had a shorter length of hospital stay postoperatively compared to the control group patients.