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Somatostatin analogues for the prevention of pancreatic fistula after open pancreatoduodenectomy: A nationwide analysis

BACKGROUND: Somatostatin analogues (SA) are currently used to prevent postoperative pancreatic fistula (POPF) development. However, its use is controversial. This study investigated the effect of different SA protocols on the incidence of POPF after pancreatoduodenectomy in a nationwide population.... Full description

Journal Title: Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] 2022, Vol.22 (3), p.421-426
Main Author: Bootsma, Boukje T
Other Authors: Plat, Victor D , van de Brug, Tim , Huisman, Daitlin E , Botti, M , van den Boezem, Peter B , Bonsing, Bert A , Bosscha, Koop , Dejong, Cornelis H C , Groot-Koerkamp, Bas , Hagendoorn, Jeroen , van der Harst, Erwin , de Hingh, Ignace H , de Meijer, Vincent E , Luyer, Misha D , Nieuwenhuijs, Vincent B , Pranger, Bobby K , van Santvoort, Hjalmar C , Wijsman, Jan H , Zonderhuis, Barbara M , Kazemier, Geert , Besselink, Marc G , Daams, Freek
Format: Electronic Article Electronic Article
Language: English
Quelle: Alma/SFX Local Collection
ID: ISSN: 1424-3903
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recordid: cdi_narcis_primary_rug_oai_pure_rug_nl_publications_0d3894cb_cf1b_4789_bf48_58a91c726b95
title: Somatostatin analogues for the prevention of pancreatic fistula after open pancreatoduodenectomy: A nationwide analysis
format: Article
creator:
  • Bootsma, Boukje T
  • Plat, Victor D
  • van de Brug, Tim
  • Huisman, Daitlin E
  • Botti, M
  • van den Boezem, Peter B
  • Bonsing, Bert A
  • Bosscha, Koop
  • Dejong, Cornelis H C
  • Groot-Koerkamp, Bas
  • Hagendoorn, Jeroen
  • van der Harst, Erwin
  • de Hingh, Ignace H
  • de Meijer, Vincent E
  • Luyer, Misha D
  • Nieuwenhuijs, Vincent B
  • Pranger, Bobby K
  • van Santvoort, Hjalmar C
  • Wijsman, Jan H
  • Zonderhuis, Barbara M
  • Kazemier, Geert
  • Besselink, Marc G
  • Daams, Freek
ispartof: Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.], 2022, Vol.22 (3), p.421-426
description: BACKGROUND: Somatostatin analogues (SA) are currently used to prevent postoperative pancreatic fistula (POPF) development. However, its use is controversial. This study investigated the effect of different SA protocols on the incidence of POPF after pancreatoduodenectomy in a nationwide population. METHODS: All patients undergoing elective open pancreatoduodenectomy were included from the Dutch Pancreatic Cancer Audit (2014-2017). Patients were divided into six groups: no SA, octreotide, lanreotide, pasireotide, octreotide only in high-risk (HR) patients and lanreotide only in HR patients. Primary endpoint was POPF grade B/C. The updated alternative Fistula Risk Score was used to compare POPF rates across various risk scenarios. RESULTS: 1992 patients were included. Overall POPF rate was 13.1%. Lanreotide (10.0%), octreotide-HR (9.4%) and no protocol (12.7%) POPF rates were lower compared to the other protocols (varying from 15.1 to 19.1%, p = 0.001) in crude analysis. Sub-analysis in patients with HR of POPF showed a significantly lower rate of POPF when treated with lanreotide (10.0%) compared to no protocol, octreotide and pasireotide protocol (21.6-26.9%, p = 0.006). Octreotide-HR and lanreotide-HR protocol POPF rates were comparable to lanreotide protocol, however not significantly different from the other protocols. Multivariable regression analysis demonstrated lanreotide protocol to be positively associated with a low odds-ratio (OR) for POPF (OR 0.387, 95% CI 0.180-0.834, p = 0.015). In-hospital mortality rates were not affected. CONCLUSION: Use of lanreotide in all patients undergoing pancreatoduodenectomy has a potential protective effect on POPF development. Protocols for HR patients only might be favorable too. However, future studies are warranted to confirm these findings.
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 1424-3903
fulltext: fulltext
issn:
  • 1424-3903
  • 1424-3911
url: Link


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titleSomatostatin analogues for the prevention of pancreatic fistula after open pancreatoduodenectomy: A nationwide analysis
sourceAlma/SFX Local Collection
creatorBootsma, Boukje T ; Plat, Victor D ; van de Brug, Tim ; Huisman, Daitlin E ; Botti, M ; van den Boezem, Peter B ; Bonsing, Bert A ; Bosscha, Koop ; Dejong, Cornelis H C ; Groot-Koerkamp, Bas ; Hagendoorn, Jeroen ; van der Harst, Erwin ; de Hingh, Ignace H ; de Meijer, Vincent E ; Luyer, Misha D ; Nieuwenhuijs, Vincent B ; Pranger, Bobby K ; van Santvoort, Hjalmar C ; Wijsman, Jan H ; Zonderhuis, Barbara M ; Kazemier, Geert ; Besselink, Marc G ; Daams, Freek
creatorcontribBootsma, Boukje T ; Plat, Victor D ; van de Brug, Tim ; Huisman, Daitlin E ; Botti, M ; van den Boezem, Peter B ; Bonsing, Bert A ; Bosscha, Koop ; Dejong, Cornelis H C ; Groot-Koerkamp, Bas ; Hagendoorn, Jeroen ; van der Harst, Erwin ; de Hingh, Ignace H ; de Meijer, Vincent E ; Luyer, Misha D ; Nieuwenhuijs, Vincent B ; Pranger, Bobby K ; van Santvoort, Hjalmar C ; Wijsman, Jan H ; Zonderhuis, Barbara M ; Kazemier, Geert ; Besselink, Marc G ; Daams, Freek
descriptionBACKGROUND: Somatostatin analogues (SA) are currently used to prevent postoperative pancreatic fistula (POPF) development. However, its use is controversial. This study investigated the effect of different SA protocols on the incidence of POPF after pancreatoduodenectomy in a nationwide population. METHODS: All patients undergoing elective open pancreatoduodenectomy were included from the Dutch Pancreatic Cancer Audit (2014-2017). Patients were divided into six groups: no SA, octreotide, lanreotide, pasireotide, octreotide only in high-risk (HR) patients and lanreotide only in HR patients. Primary endpoint was POPF grade B/C. The updated alternative Fistula Risk Score was used to compare POPF rates across various risk scenarios. RESULTS: 1992 patients were included. Overall POPF rate was 13.1%. Lanreotide (10.0%), octreotide-HR (9.4%) and no protocol (12.7%) POPF rates were lower compared to the other protocols (varying from 15.1 to 19.1%, p = 0.001) in crude analysis. Sub-analysis in patients with HR of POPF showed a significantly lower rate of POPF when treated with lanreotide (10.0%) compared to no protocol, octreotide and pasireotide protocol (21.6-26.9%, p = 0.006). Octreotide-HR and lanreotide-HR protocol POPF rates were comparable to lanreotide protocol, however not significantly different from the other protocols. Multivariable regression analysis demonstrated lanreotide protocol to be positively associated with a low odds-ratio (OR) for POPF (OR 0.387, 95% CI 0.180-0.834, p = 0.015). In-hospital mortality rates were not affected. CONCLUSION: Use of lanreotide in all patients undergoing pancreatoduodenectomy has a potential protective effect on POPF development. Protocols for HR patients only might be favorable too. However, future studies are warranted to confirm these findings.
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3Huisman, Daitlin E
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6Bonsing, Bert A
7Bosscha, Koop
8Dejong, Cornelis H C
9Groot-Koerkamp, Bas
10Hagendoorn, Jeroen
11van der Harst, Erwin
12de Hingh, Ignace H
13de Meijer, Vincent E
14Luyer, Misha D
15Nieuwenhuijs, Vincent B
16Pranger, Bobby K
17van Santvoort, Hjalmar C
18Wijsman, Jan H
19Zonderhuis, Barbara M
20Kazemier, Geert
21Besselink, Marc G
22Daams, Freek
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0Somatostatin analogues for the prevention of pancreatic fistula after open pancreatoduodenectomy: A nationwide analysis
1Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.]
descriptionBACKGROUND: Somatostatin analogues (SA) are currently used to prevent postoperative pancreatic fistula (POPF) development. However, its use is controversial. This study investigated the effect of different SA protocols on the incidence of POPF after pancreatoduodenectomy in a nationwide population. METHODS: All patients undergoing elective open pancreatoduodenectomy were included from the Dutch Pancreatic Cancer Audit (2014-2017). Patients were divided into six groups: no SA, octreotide, lanreotide, pasireotide, octreotide only in high-risk (HR) patients and lanreotide only in HR patients. Primary endpoint was POPF grade B/C. The updated alternative Fistula Risk Score was used to compare POPF rates across various risk scenarios. RESULTS: 1992 patients were included. Overall POPF rate was 13.1%. Lanreotide (10.0%), octreotide-HR (9.4%) and no protocol (12.7%) POPF rates were lower compared to the other protocols (varying from 15.1 to 19.1%, p = 0.001) in crude analysis. Sub-analysis in patients with HR of POPF showed a significantly lower rate of POPF when treated with lanreotide (10.0%) compared to no protocol, octreotide and pasireotide protocol (21.6-26.9%, p = 0.006). Octreotide-HR and lanreotide-HR protocol POPF rates were comparable to lanreotide protocol, however not significantly different from the other protocols. Multivariable regression analysis demonstrated lanreotide protocol to be positively associated with a low odds-ratio (OR) for POPF (OR 0.387, 95% CI 0.180-0.834, p = 0.015). In-hospital mortality rates were not affected. CONCLUSION: Use of lanreotide in all patients undergoing pancreatoduodenectomy has a potential protective effect on POPF development. Protocols for HR patients only might be favorable too. However, future studies are warranted to confirm these findings.
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authorBootsma, Boukje T ; Plat, Victor D ; van de Brug, Tim ; Huisman, Daitlin E ; Botti, M ; van den Boezem, Peter B ; Bonsing, Bert A ; Bosscha, Koop ; Dejong, Cornelis H C ; Groot-Koerkamp, Bas ; Hagendoorn, Jeroen ; van der Harst, Erwin ; de Hingh, Ignace H ; de Meijer, Vincent E ; Luyer, Misha D ; Nieuwenhuijs, Vincent B ; Pranger, Bobby K ; van Santvoort, Hjalmar C ; Wijsman, Jan H ; Zonderhuis, Barbara M ; Kazemier, Geert ; Besselink, Marc G ; Daams, Freek
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1Plat, Victor D
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3Huisman, Daitlin E
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issn1424-3903
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abstractBACKGROUND: Somatostatin analogues (SA) are currently used to prevent postoperative pancreatic fistula (POPF) development. However, its use is controversial. This study investigated the effect of different SA protocols on the incidence of POPF after pancreatoduodenectomy in a nationwide population. METHODS: All patients undergoing elective open pancreatoduodenectomy were included from the Dutch Pancreatic Cancer Audit (2014-2017). Patients were divided into six groups: no SA, octreotide, lanreotide, pasireotide, octreotide only in high-risk (HR) patients and lanreotide only in HR patients. Primary endpoint was POPF grade B/C. The updated alternative Fistula Risk Score was used to compare POPF rates across various risk scenarios. RESULTS: 1992 patients were included. Overall POPF rate was 13.1%. Lanreotide (10.0%), octreotide-HR (9.4%) and no protocol (12.7%) POPF rates were lower compared to the other protocols (varying from 15.1 to 19.1%, p = 0.001) in crude analysis. Sub-analysis in patients with HR of POPF showed a significantly lower rate of POPF when treated with lanreotide (10.0%) compared to no protocol, octreotide and pasireotide protocol (21.6-26.9%, p = 0.006). Octreotide-HR and lanreotide-HR protocol POPF rates were comparable to lanreotide protocol, however not significantly different from the other protocols. Multivariable regression analysis demonstrated lanreotide protocol to be positively associated with a low odds-ratio (OR) for POPF (OR 0.387, 95% CI 0.180-0.834, p = 0.015). In-hospital mortality rates were not affected. CONCLUSION: Use of lanreotide in all patients undergoing pancreatoduodenectomy has a potential protective effect on POPF development. Protocols for HR patients only might be favorable too. However, future studies are warranted to confirm these findings.
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