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

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. All patients... 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
Subjects:
Quelle: Alma/SFX Local Collection
Publisher: Switzerland: Elsevier B.V
ID: ISSN: 1424-3903
Link: https://www.ncbi.nlm.nih.gov/pubmed/35304104
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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
subjects:
  • Body mass index
  • Complications and side effects
  • Endoscopy
  • Fistula
  • Fistulae
  • Health aspects
  • Hemorrhage
  • Hospitals
  • Humans
  • Lanreotide
  • Laparoscopy
  • Length of stay
  • Mortality
  • Neuroendocrine tumors
  • Octreotide
  • Octreotide - therapeutic use
  • Pancreas - surgery
  • Pancreatic cancer
  • Pancreatic Fistula - epidemiology
  • Pancreatic Fistula - etiology
  • Pancreatic Fistula - prevention & control
  • Pancreaticoduodenectomy
  • Pancreaticoduodenectomy - adverse effects
  • Pancreatoduodenectomy
  • Pasireotide
  • Pathology
  • Patient outcomes
  • Patients
  • Postoperative Complications - epidemiology
  • Postoperative Pancreatic Fistula
  • Prevention
  • Risk Factors
  • Somatostatin
  • Somatostatin - therapeutic use
  • Somatostatin analogues
  • Surgery
  • Surgical outcomes
ispartof: Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.], 2022, Vol.22 (3), p.421-426
description: 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. 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. 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. 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
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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 ; Dutch Pancreatic Cancer Group
descriptionSomatostatin 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. 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. 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. 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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1EISSN: 1424-3911
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languageeng
publisherSwitzerland: Elsevier B.V
subjectBody mass index ; Complications and side effects ; Endoscopy ; Fistula ; Fistulae ; Health aspects ; Hemorrhage ; Hospitals ; Humans ; Lanreotide ; Laparoscopy ; Length of stay ; Mortality ; Neuroendocrine tumors ; Octreotide ; Octreotide - therapeutic use ; Pancreas - surgery ; Pancreatic cancer ; Pancreatic Fistula - epidemiology ; Pancreatic Fistula - etiology ; Pancreatic Fistula - prevention & control ; Pancreaticoduodenectomy ; Pancreaticoduodenectomy - adverse effects ; Pancreatoduodenectomy ; Pasireotide ; Pathology ; Patient outcomes ; Patients ; Postoperative Complications - epidemiology ; Postoperative Pancreatic Fistula ; Prevention ; Risk Factors ; Somatostatin ; Somatostatin - therapeutic use ; Somatostatin analogues ; Surgery ; Surgical outcomes
ispartofPancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.], 2022, Vol.22 (3), p.421-426
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0Bootsma, Boukje T.
1Plat, Victor D.
2van de Brug, Tim
3Huisman, Daitlin E.
4Botti, M.
5van den Boezem, Peter B.
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
23Dutch Pancreatic Cancer Group
title
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.]
addtitlePancreatology
descriptionSomatostatin 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. 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. 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. 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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0Body mass index
1Complications and side effects
2Endoscopy
3Fistula
4Fistulae
5Health aspects
6Hemorrhage
7Hospitals
8Humans
9Lanreotide
10Laparoscopy
11Length of stay
12Mortality
13Neuroendocrine tumors
14Octreotide
15Octreotide - therapeutic use
16Pancreas - surgery
17Pancreatic cancer
18Pancreatic Fistula - epidemiology
19Pancreatic Fistula - etiology
20Pancreatic Fistula - prevention & control
21Pancreaticoduodenectomy
22Pancreaticoduodenectomy - adverse effects
23Pancreatoduodenectomy
24Pasireotide
25Pathology
26Patient outcomes
27Patients
28Postoperative Complications - epidemiology
29Postoperative Pancreatic Fistula
30Prevention
31Risk Factors
32Somatostatin
33Somatostatin - therapeutic use
34Somatostatin analogues
35Surgery
36Surgical outcomes
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1Plat, Victor D.
2van de Brug, Tim
3Huisman, Daitlin E.
4Botti, M.
5van den Boezem, Peter B.
6Bonsing, Bert A.
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8Dejong, Cornelis H.C.
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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
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titleSomatostatin analogues for the prevention of pancreatic fistula after open pancreatoduodenectomy: A nationwide analysis
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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1Complications and side effects
2Endoscopy
3Fistula
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5Health aspects
6Hemorrhage
7Hospitals
8Humans
9Lanreotide
10Laparoscopy
11Length of stay
12Mortality
13Neuroendocrine tumors
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15Octreotide - therapeutic use
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18Pancreatic Fistula - epidemiology
19Pancreatic Fistula - etiology
20Pancreatic Fistula - prevention & control
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22Pancreaticoduodenectomy - adverse effects
23Pancreatoduodenectomy
24Pasireotide
25Pathology
26Patient outcomes
27Patients
28Postoperative Complications - epidemiology
29Postoperative Pancreatic Fistula
30Prevention
31Risk Factors
32Somatostatin
33Somatostatin - therapeutic use
34Somatostatin analogues
35Surgery
36Surgical outcomes
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8Dejong, Cornelis H.C.
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abstractSomatostatin 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. 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. 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. 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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