Systematic review and meta-analysis of the role of somatostatin and its analogues in the treatment of enterocutaneous fistula

Eur J Gastroenterol Hepatol. 2011 Oct;23(10):912-22. doi: 10.1097/MEG.0b013e32834a345d.

Abstract

Objective: Somatostatin analogues may help pancreatic fistula although it remains unclear whether they help nonpancreatic fistula. This study involved meta-analysis of somatostatin analogues for treatment of enterocutaneous fistula.

Methods: Meta-analysis of studies was undertaken, to estimate the effect of somatostatin analogues on spontaneous closure, time to closure and mortality.

Results: Results showed significant associations between somatostatin and both spontaneous closure rate [odds ratio (OR) 6.61, 95% (CI) confidence interval 1.35-32.43] and time to closure (standardized mean difference -0.80, 95% CI: -1.34 to -0.26). Octreotide reduced closure time (standardized mean difference -0.57, 95% CI: -0.95 to -0.20) but not spontaneous closure (OR: 1.74, 95% CI: 0.64-4.76). Lanreotide also improved time to closure (mean of 17 days vs. 26 days, standard deviation not stated) but not spontaneous closure (OR: 0.94, 95% CI: 0.42-2.12). Somatostatin, octreotide and lanreotide did not significantly affect mortality (OR: 0.30, 0.82, and 0.48; 95% CI: 0.03-3.47, 0.38-1.78, and 0.04-5.07 respectively).

Conclusion: Somatostatin and octreotide improved fistula closure time but only somatostatin improved spontaneous closure rate.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Gastrointestinal Agents / therapeutic use*
  • Humans
  • Intestinal Fistula / drug therapy*
  • Male
  • Middle Aged
  • Octreotide / therapeutic use
  • Somatostatin / analogs & derivatives
  • Somatostatin / therapeutic use*
  • Treatment Outcome
  • Young Adult

Substances

  • Gastrointestinal Agents
  • Somatostatin
  • Octreotide