Effect of somatostatin on exocrine pancreas evaluated on a total external pancreatic fistula of neoplastic origin.

A patient with a pancreatic fistula, with a defunctionalized duodenum (subsequent to a previously performed Billroth II gastrectomy for cancer and choledochojejunostomy for metastatic infiltration in the bile duct) was submitted to prolonged synthetic somatostatin infusion (48 h). There was a mean reduction of 80% in pancreatic output, with no changes in the composition of sodium, potassium, and calcium, an increase in chloride and a decrease in bicarbonate. An increase in amylase was noted. The unique clinical features of this case have provided direct confirmation of the inhibiting action of somatostatin on the exocrine pancreas.