Role of octreotide in postoperative enterocutaneous fistula

ABSTRACT

Postoperative enterocutaneous fistulae, a serious complication of gastrointestinal surgery are associated with significant morbidity and mortality. Its management is based on nutritional support, control of sepsis, skin and wound care while waiting for fistula to close. Octreotide, a long acting somatostatin analogue, reduces gastrointestinal secretions and motility, hence reducing fistula output. Thirty one patients with postoperative enterocutaneous fistulae were administered octreotide subcutaneously and its effect on fistula output, till closing time were noted. There was a significant reduction in the fistula output, in 23[74%] patients fistula closed spontaneously in second week. Skin and wound were also easily managed. Although fistulahealing time was apparently reduced but, it was not possible to prove reduction in healing time convincingly, as to this end, controlled double blind trials are required. It is however, concluded that octreotide significantly reduces the morbidity by reducing - fistula output and assists in better skin and wound care