Prophylactic octreotide in the prevention of pancreatic fistula and its related complications after pancreatic resection: a Meta-analysis / 中华肝胆外科杂志

ABSTRACT

Objective To study the clinical impact of prophylactic octreotide on patients who underwent pancreatic resection using evidence-based medicine.Methods Electronic databases which included the Cochrane library,Pubmed and Embase were searched.A Meta-analysis of all randomized controlled trials (RCTs) on the clinical impact of prophylactic octreotide on pancreatic resection was performed.The evaluation of the literature quality and the effective of the data were based on the Cochrane Handbook for systematic reviews.The Review Manager 5.3 was used for the meta-analysis.Results 13 studies which involved 2 108 patients were included into this study,with 1 057 patients in the octreotide group and 1 051 patients in the control group.Meta-analysis revealed that the rates of pancreatic fistula (PF),including Class A,B and C and the total postoperative complication rate were lower in patients treated with prophylactic octreotide than those without octreotide (14.7％ vs.21.6％,RR =0.67,95％ CI0.56-0.81,P ＜ 0.05;25.7％ vs.35.7％,RR =0.71,95％ CI0.58-0.87,P ＜0.05).However,octreotide did not significantly reduce the incidences of clinically relevant fistulas including Class B and C,perioperative mortality,delayed gastric enptying,bleeding,abdominal infection,postoperative pancreatitis,and re-operation (all P ＞ 0.05).Conclusion Octreotide reduced PF including Class A,B and C and decreased the total complication rate,but did not reduce the clinically relevant fistulas and perioperative mortality.