Abstract
A patient who was admitted to our hospital to undergo surgery for a dissecting thoracic aneurysm suffered preoperatively from severe acute pancreatitis with pancreatic pseudocysts. Computerized tomography (CT) demonstrated the presence of new fluid collection around the cyst with the absence of pancreatic necrosis. He was given a somatostatin analog (sandostatin), which was effective in decreasing the abdominal symptoms, leukocyte counts, and the serum Creactive/protein level. A CT scan revealed that the pancreatic pseudocyst and peripancreatic fluid collection had disappeared. Although somatostatin has been reported to be ineffective for acute pancreatitis with necrosis, pancreatitis without necrosis may regress after treatment with sandostatin. This is probably due to its suppressive effect on the exocrine function, thus resulting in a decrease of pancreatic juice infiltration.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Haas GS, Warshaw AL, Daggett WM et al (1985) Acute pancreatitis after cardiopulmonary bypass. Am J Surg 149:508–515
Pemberton JH, Becker JM, Dozois RR et al (1986) Controlled open lesser sac drainage for pancreatic abscess. Ann Surg 203:600–604
Malangoni MA, Shallcross JC, Seiler JG et al (1986) Factors contributing to fatal outcome after treatment of pancreatic abscess. Ann Surg 203:605–613
Wilson C, McArdle CS, Carter DC et al (1988) Surgical treatment of acute necrotizing pancreatitis. Br J Surg 75:1119–1123
Fugger R, Schulz F, Rogy M et al (1991) Open approach in pancreatic and infected pancreatic necrosis: laparostomies and preplanned revisions. World J Surg 15:516–521
Feiner H (1976) Pancreatitis after cardiac surgery: a morphological study. Am J Surg 131:684–688
Saitoh Y, Yamamoto M (1991) Evaluation of severity of acute pancreatitis, according to a report of the cooperative national survey in Japan. Int J Pancreatol 9:51–58
Boden G, Sivitz MC, Owen OE et al (1975) Somatostatin suppresses secretin and pancreatic exocrine secretion. Science 190:163–165
Raptis S, Schlegel W, Lehmann E et al (1978) Effects of somatostatin on the exocrine pancreas and the release of duodenal hormones. Metabolism 27 (suppl 1): 1321–1328
Susini C, Esteve JP, Vaysse N et al (1980) Somatostatin 28: effects on exocrine pancreatic secretion in conscious dogs. Gastroenterology 79:720–724
Gjorup I, Roikjaer O, Andersen B (1992) A double blinded multicenter trial of somatostatin in the treatment of acute pancreatitis. Surg Gynecol Obstet 175:397–400
Choi TK, Mok F, Zhan WH (1989) Somatostatin in the treatment of acute pancreatitis: a prospective randomized controlled trial. Gut 30:223–227
Usadel KH, Uberla K, Leuschner U (1985) Treatment of acute pancreatitis with somatostatin: results of the multicenter doubleblind trial. Dig Dis Sci 30:992
Miyasaka Y, Ono K (1996) A case of pancreatic pleural effusion and ascites treated successfully with conservative measures including octreotide and nafamostat mesilate. Nippon Shokakibyo Gakkai Zasshi (Jpn J Gastroenterol) 93:937–941
Yamao K, Nakazawa S (1996) Successful treatment of a large pancreatic pseudocyst with a percutaneous catheter drainage and a somatostatin analogue: report of a case. Nippon Shokakibyo Gakkai Zasshi (Jpn J Gastroenterol) 93:942–946
Beger HG, Kunz R, Bittner R (1987) Prognostic criteria in necrotizing pancreatitis. In: Beger HG, Buchler M (eds) Acute pancreatitis. Springer, Berlin Heidelberg New York Tokyo, pp 198–200
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Matsumoto, J., Kimura, W., Kawauchi, M. et al. Management of severe acute pancreatitis with a somatostatin analog in a patient undergoing surgery for dissecting thoracic aneurysm: Report of a case. Surg Today 29, 911–914 (1999). https://doi.org/10.1007/BF02482785
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02482785