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01-11-2016 | ORIGINAL ARTICLE

Perioperative application of somatostatin analogs for pancreatic surgery—current status in Germany

Authors: Andreas Volk, Philipp Nitschke, Franziska Johnscher, Nuh Rahbari, Thilo Welsch, Christoph Reißfelder, Jürgen Weitz, Marius Distler, Soeren Torge Mees

Published in: Langenbeck's Archives of Surgery | Issue 7/2016

Abstract

Background

The most common major complication after pancreatic resection is the postoperative pancreatic fistula (POPF). Somatostatin analogs can reduce POPF, but the use of somatostatin analogs is still controversial. The aim of this study was to assess treatment algorithms for pancreatic surgery in Germany with a special focus on the application of somatostatin analogs.

Methods

A questionnaire evaluating the perioperative management–especially the use of somatostatin analogs—and postoperative complications after pancreatic surgery was developed and sent to 209 German hospitals performing >12 pancreatoduodenectomies per year (the requirement for certification as a pancreas center). Statistical analysis was carried out using SPSS 21.

Results

The final response rate was 77 % (160/209), 14.5 % of hospitals never, 37 % always, and 45 % occasionally apply somatostatin analogs after pancreatic surgery. A (standard) drug of choice was defined in 64 % of hospitals. When standard and occasional usage was analyzed, it appeared that hospitals favored somatostatin (69 %) > sandostatin (50 %) > pasireotide (5 %). A relation between the usage of the different somatostatin analogs and morbidity (POPF) or mortality (84 and 16 % of hospitals reported <5 and 5–10 %, respectively) was not seen. Eighty-seven percent of hospitals were interested in participating in future studies analyzing somatostatin use.

Conclusion

This is the first national survey in Germany evaluating the perioperative application of somatostatin analogs for pancreatic surgery. Despite controversial results in the literature, the majority of German pancreas surgeons apply somatostatin analogs perioperatively. The ideal drug to reduce POPF is still unclear. This uncertainty has aroused significant interest and prompted surgeons to participate in future studies in order to elucidate this issue.

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Title: Perioperative application of somatostatin analogs for pancreatic surgery—current status in Germany
Authors: Andreas Volk
Philipp Nitschke
Franziska Johnscher
Nuh Rahbari
Thilo Welsch
Christoph Reißfelder
Jürgen Weitz
Marius Distler
Soeren Torge Mees
Publication date: 01-11-2016
Publisher: Springer Berlin Heidelberg
Published in: Langenbeck's Archives of Surgery / Issue 7/2016
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-016-1502-4

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Perioperative application of somatostatin analogs for pancreatic surgery—current status in Germany

Abstract

Background

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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