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2003, Number 2

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Cir Gen 2003; 25 (2)

Usefulness of octreotide as adjuvant in the management of severe acute pancreatitis

Ruy-Díaz RJA, Mijares-García JM, Thompson CÓ, Herrera-Esquivel JJ, Cárdenas-Lailson LE

Language: Spanish
References: 27
Page: 130-136
PDF size: 71.28 Kb.


ABSTRACT

Objective: To assess the usefulness of octreotide as adjuvant in the treatment of severe acute pancreatitis.
Design: Prospective, randomized, comparative, experimental, longitudinal study.
Statistical analysis: Student’s t, ANOVA, and Chi square tests were used; p = 0-05.
Patients and methods: Patients of either sex coursing with severe acute pancreatitis. We analyzed gender, age, Ranson and APACHE II scores, tomographic criteria, morbidity, mortality, days of nutritional support, inflammatory response (at admittance and on the 5th day), and duration of hospital stay. Patients were divided in: Experimental group (EG) managed with 300 mg/day of octreotide, applied subcutaneously, for 72 hours. Control group (CG) without octreotide. Both groups were treated according to a protocol already established at our hospital.
Results: Seventy-six patients with severe acute pancreatitis were studied. No differences in Ranson scoring existed at admittance (p = 0.333), at 48 hours (p = 0.481) and in APACHE II at admittance (p = 0.288), at 48 hours (p = 0.371). Biliary etiology was the most frequent (53.9%). General mortality was of 2.6% (p = 0.351). Morbidity was of 39.4% for EG versus 94.7% for CG (p = 0.049). Leukocyte count at admittance was of 15,513 ± 5,147 cells/mm3 for EG and 15,689 ± 5,193 cells/mm3 for CG. On the 5th day, it decreased to 9,426 ± 2,804 cells/mm3 for EG and to 11,703 ± 3,551 cells/mm3 for CG (p = 0.000). Hospital stay was of 10.2 ± 4.1 days (EG) and 19 ± 13.8 days for CG (p = 0.000).
Conclusion: Octreotide is useful as an adjuvant in severe acute pancreatitis. It decreases morbidity as well as the duration of the systemic inflammatory response and of hospital stay.


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