Somatostatin for the prevention of complications following pancreatoduodenectomy.

Pancreatoduodenectomy (PD) may be followed by serious complications chiefly associated with exocrine pancreatic secretion. Somatostatin and its analogues are able to inhibit pancreatic secretion and thus have been advocated for the prevention of complications following pancreatic surgery. In four published multicentric randomized trials, octreotide administration was associated with a decrease in overall complication rate. However and surprisingly, the benefit is less clear when focusing on complications associated with pancreatic secretion as in pancreatic fistula or in high-risk patients (PD and nonfibrotic pancreas). The efficiency of other somatostatin analogues has not yet been assessed in randomized trials. In conclusion, further studies would be useful before routine prophylactic administration of somatostatin analogues can be recommended.