Prevention of severe acute pancreatitis with octreotide in obese patients: a prospective multi-center randomized controlled trial.

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Prevention of severe acute pancreatitis with octreotide in obese patients: a prospective multi-center randomized controlled trial.

Pancreas. 2012 Nov;41(8):1206-12

Authors: Yang F, Wu H, Li Y, Li Z, Wang C, Yang J, Hu B, Huang Z, Ji R, Zhan X, Xie H, Wang L, Zhang M, Tang C

Abstract
OBJECTIVES: To evaluate the efficacy of octreotide in preventing severe acute pancreatitis (SAP) in obese patients.
METHODS: A prospective multi-center partly randomized control trial was conducted in patients with mild acute pancreatitis (AP). Nonobese patients received conventional management (nonobese-C, n = 82), whereas obese patients (body mass index ≥ 25 kg/m(2)) were randomized into 2 groups: obese-C (n = 79), who received conventional management, and obese-C+O (n = 82), who received conventional management plus intravenous infusion of octreotide, 50 μg/h for 72 hours.
RESULTS: The risk ratio and relative risk reduction in the development of SAP in the obese-C+O group were 0.27 (95% confidence interval, 0.10-0.69) and 0.73 (95% confidence interval, 0.31-0.90), respectively. The number of cases developing local complications in the obese-C+O group was significantly smaller than that in the obese-C group: 4.9% vs 19%, P = 0.006. The plasma level of somatostatin in the obese-C+O group was significantly higher than that in the obese-C group: 165.5 ± 42.6 vs 112.1 ± 24.86 pg/mL, P < 0.05. Supplement of octreotide also accompanied with reduction in plasma levels of tumor necrosis factor α and IL-6.
CONCLUSIONS: Intravenous administration of octreotide (50 μg/h) for 72 hours in the early stage of AP could prevent the development of SAP effectively in obese patients by raising plasma somatostatin to a normal level and reducing circulating cytokines.

PMID: 23086244 [PubMed - indexed for MEDLINE]

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