Octreotide administration in the treatment of pancreatic fistulae after pancreas transplantation |
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Authors: | Antonio Secchi Valerio Di Carlo Sabina Martinenghi Ennio La Rocca Rossana Caldara Carlo Staudacher Giovanni Ferrari Renato Castoldi Giorgio Torri Guido Pozza |
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Institution: | (1) Department of Medicine, Università di Milano, Via Olgettina 60, I-20132 Milan, Italy;(2) Department of Surgery, Università di Milano, Via Olgettina 60, I-20132 Milan, Italy;(3) Intensive Care Unit, Istituto Scientifico San Raffaele, Università di Milano, Via Olgettina 60, I-20132 Milan, Italy |
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Abstract: | Among the surgical complications of pancreas transplantation are pancreatic fistulae, which arise rather frequently. Suppression of exocrine secretion with polymers has succeeded in reducing the rate of this complication. Nevertheless, in some instances, pancreatic fistulas may occur. Thirty pancreas transplantations were performed in 27 diabetic patients. In 5 cases a pancreatic fistula occurred and was drained after the insertion of a catheter for the collection of secretions. A serous liquid was collected with a high concentration of amylases (61604±19562 IU/24h). Fistula output was 280 ±87 ml/24 h. Patients were treated with octreotide, administered subcutaneously in a dose of 300–750 g/day. In all patients a progressive reduction in fistula output was observed after a mean of 16+2 days. Fistula flow rate dropped to 24±10 ml/24 h-areduction of 95%±5% and drainage was subsequently stopped. Sonographic followup did not show recurrence of peripancreatic collections in these patients. All patients were insulin-independent up to 12–44 months after surgery. |
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Keywords: | Pancreas transplantation fistula Fistula pancreas transplantation Octreotide fistula pancreas transplantation |
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