Superiority of Somatostatin Analog in Comparison With Drugs for Treating Pancreatic Fistula in Rats

Objective: This study aims to identify the most effective individual drug in an established triple-drug therapy (TDT) using a postoperative pancreatic fistula (POPF) rat model. Summary of background data: POPF is the major complication of pancreatectomy that causes intraperitoneal abscess, sepsis, and pseudoaneurysm rupture, all of which may prolong hospital stays and cause potentially serious events or death. We previously demonstrated that TDT with a somatostatin analog, gabexate mesilate, and imipenem/ cilastatin effectively prevents POPF, especially in high-risk patients. Methods: POPF-induced rats were killed on postoperative day 3 after control (C), gabexate mesilate (G), imipenem/cilastatin (I), and somatostatin analog (S) treatments. Levels of serum amylase and lipase, or ascitic amylase and lipase were measured. Intraperitoneal adhesion between the abdominal wall and pancreas and pancreatic inflammation were evaluated. Results: Serum amylase levels did not significantly differ among the groups. Serum lipase level was significantly higher in group I than in the other groups (P < 0.01). Both ascitic amylase and lipase levels were significantly lower in group S than in the other groups (P < 0.01). Median inflammation scores were significantly lower in groups G, I, and S than in group C (P < 0.01). Moreover, adhesion score was lower in group S than in the other groups (groups C, G, I, and S with scores 3, 2, 3, and 1, respectively, P < 0.01). Conclusion: Among the 3 drugs, the somatostatin analog was the most effective against POPF.

Automated summary

The objective of this study was to identify the most effective individual drug in a triple-drug therapy for preventing postoperative pancreatic fistula (POPF) using a rat model. The researchers compared the effects of a somatostatin analog, gabexate mesilate, and imipenem/cilastatin on POPF in rats and evaluated levels of serum amylase and lipase, ascitic amylase and lipase, intraperitoneal adhesion, and pancreatic inflammation. The results showed that the somatostatin analog was the most effective drug against POPF, as it significantly reduced levels of ascitic amylase and lipase and inflammation in the pancreas.