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Collection of lymphatic fluid in the chest cavity is called chylothorax. Routine management of this condition involves treatment of the underlying condition, draining of fluid, putting a tube in the chest wall until all the fluid is drained and rarely surgery. Octreotide is a drug that may reduce the production and accumulation of fluid and allow babies to recover faster. No trials have evaluated the safety and efficacy of this drug in babies and only case reports are available. Future studies are needed.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Variceal bleeding in cirrhosis is associated with a high risk of death. Although banding ligation of varices is considered the choice for endoscopic treatment, emergency sclerotherapy is frequently used particularly where ligation is not available or when it is not feasible. However, vasoactive drugs stop bleeding in most patients, and emergency sclerotherapy may carry risks to the patient and is more demanding on the health‐care system. All of the identified randomised clinical trials comparing emergency sclerotherapy with vasopressin (+/‐ intravenous or transdermal nitroglycerin), terlipressin, somatostatin, or octreotide have been reviewed. A total of 17 randomised trials including 1817 patients were included. Sclerotherapy did not appear to be superior to the vasoactive drugs in terms of control of bleeding, number of transfusions, 42‐day rebleeding and mortality, or rebleeding and mortality before other elective treatments. However, adverse events were significantly more frequent and severe with sclerotherapy than with vasoactive drugs.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Pancreatic resections are associated with high morbidity (30% to 60%) and mortality (5%). It is not clear whether routine, preventive use of synthetic analogues of somatostatin (a hormone that inhibits pancreatic secretions) could reduce complications following pancreatic surgery. We included 21 randomised clinical trials in this review. All trials had high risk of bias ('systematic error'). A total of 2348 people were randomised either to somatostatin analogues or a control in the 21 trials. The overall number of people with postoperative complications was lower by 30% in the somatostatin analogues group but there was no difference in postoperative mortality, re‐operation rate or overall length of hospital stay between the groups. Pancreatic fistula is drainage of pancreatic juice secreted by the remaining pancreas to the exterior. This was lower in the intervention group by 34%. The proportion of these fistulas that resulted in change to the treatment given to the participants is not clear. When we included trials that clearly distinguished fistulas that required change to the treatment given to the participants, there was no difference between the two groups. Participant quality of life was not reported in any of the trials. In conclusion, somatostatin analogues reduce the incidence of pancreatic fistula. Further trials with sufficient participant numbers and a low risk of bias are necessary. Based on the current available evidence, somatostatin and its analogues are recommended for routine use in people undergoing pancreatic resection.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Ovarian cancer is the sixth most common cancer among women and is usually diagnosed at an advanced stage. Bowel obstruction is a common feature of advanced or recurrent ovarian cancer and causes vomiting, pain and diarrhoea. Patients with bowel obstruction are generally in poor physical condition with only a short time left to live. Therefore, maintaining their QoL with effective symptom control is the main purpose of the management of bowel obstruction.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Cirrhosis of the liver is a chronic, progressing disease that is most commonly caused by excessive use of alcohol or by hepatitis C infection. The liver tissue is replaced by connective tissue, which leads to loss of liver function. People with cirrhosis of the liver may develop varicose veins (enlarged blood vessels or varices) in the gullet. Bleeding varices can be life‐threatening. The hormone somatostatin, or similar drugs like octreotide and vapreotide, can be used to try to stop the bleeding. The review of 21 trials (2588 patients) found that the tested drugs did not reduce deaths. There was a small reduction in the need for blood transfusions, corresponding to one half unit of blood saved per patient. It is doubtful whether this effect is worthwhile.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Hepatorenal syndrome is a type of renal (relating to the kidneys) failure occurring in people with severe liver disease and fluid in the abdomen (ascites). We do not fully understand why some people with liver disease develop hepatorenal syndrome, but it is generally believed that low blood pressure and reduced blood supply to the kidneys is one of the main reasons. Theoretically, drugs that increase the blood pressure may be beneficial. The drug terlipressin combined with albumin (a protein) infusion is the recommended treatment for people with hepatorenal syndrome according to guidelines. Some countries (e.g. the USA) have not approved the use of terlipressin and researchers have suggested that other vasoactive drugs may be used instead.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2017

Esophageal varices are abnormal dilatations of veins in the lower part of the swallowing tube (oesophagus) that may develop in patients with chronic liver damage (cirrhosis). Bleeding from these varices is a life threatening complication with mortality between 20 and 50 per cent. Bleeding from varices may be treated with medications and/or with an endoscope which is a flexible tube with a camera at the end which allows direct visualization and treatment of bleeding varices. The reviewers evaluated the safety and effectiveness of a drug called terlipressin: they reported that terlipressin appears to be as safe as other treatments and that terlipressin may reduce the mortality from variceal bleeding as compared to placebo. The reviewers did not have sufficient data to decide whether terlipressin was better or worse than other available treatments such as other drugs (somatostatin, octreotide) or endoscopic treatment.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

The pancreas is an organ in the abdomen (tummy) that secretes several digestive enzymes (substances that enable and speed up chemical reactions in the body) into the pancreatic ductal system before it empties into the small bowel. It also contains the Islets of Langerhans, which secrete several hormones including insulin (helps regulate blood sugar). Acute pancreatitis is life‐threatening illness characterized by sudden inflammation of the pancreas, which can lead to failure of other organs, such as the lungs and kidneys. There is a lot of research into different medical treatments for the treatment of acute pancreatitis, but it is not clear what benefits each treatment has, or indeed if any medical treatment is beneficial apart from supportive treatment. This care includes body hydration and intensive care treatment for people with organ failure (to support the failing organs). We sought to resolve this issue by searching for existing studies on the topic. We included all randomised controlled trials (clinical studies where people are randomly put into one of two or more treatment groups) whose results were reported to 7 October 2016.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: April 21, 2017

Approximately half of those relatives and friends who witness it, as well as hospital staff, find the noise of 'death rattle' distressing. For this reason, doctors and nurses try to eliminate the sound using a variety of methods, from changing the position of the patient to giving drugs to stop the noise. The aim of this review is to find out which treatment, if any, is best. Only four of 32 reports identified met the inclusion criteria for this review; none showed a convincing benefit of any single drug over any others. Some treatments may be worth trying but staff should watch carefully for any side effects of the treatment (e.g. agitation or excessively dry mouth). Anxious relatives need explanation, reassurance and discussion about any fears and concerns associated with the terminal phase and 'death rattle'. Research in this difficult area is necessary to understand the cause of the noise, its effect on the patient and those around them and the best ways of managing this condition.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2017

Expert-reviewed information summary about the treatment of pancreatic neuroendocrine tumors (islet cell tumors).

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: August 18, 2017

Expert-reviewed information summary about the treatment of gastrointestinal carcinoid tumors.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: July 19, 2016

Expert-reviewed information summary about the treatment of unusual cancers of childhood such as cancers of the head and neck, chest, abdomen, reproductive system, skin, and others.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: October 6, 2017

Expert-reviewed information summary about the treatment of pheochromocytoma and paraganglioma.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: August 18, 2017

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