Introduction: Octreotide was studied in the treatment of pure external pancreatic fistulas.
Methods: Eighteen cases (12 males, 6 females) were prospectively observed. Six patients (four after radical surgery for periampullary cancer, one endocrine tumor enucleation and one pancreojejunostomy in chronic pancreatitis) were treated as outpatients with octreotide alone because of low basal fistula output (mean+/-SD: 96.6+/-27.4 cc/24 h). Twelve (five radical surgery for cancer, five surgery for severe pancreatitis, one enucleation and one pancreojejunostomy) were treated as inpatients with octreotide plus total parenteral nutrition because of the high output (mean+/-SD: 448.4+/-248.2 cc/24 h).
Results: Ten of the 12 high-output fistulas healed in 27.8+/-27.7 days, whereas all low-output fistulas healed in 12.1+/-6.6 days.
Conclusion: Octreotide appears useful in the treatment of external pancreatic fistulas. For optimal results to be achieved, there must be no local infection and no mechanical or anatomical obstacles to the free flow of juice.