An updated systematic review and meta-analysis of the use of octreotide for the prevention of postoperative complications after pancreatic resection

Abstract

Background:The use of octreotide prophylaxis following pancreatic surgery is controversial. We aimed to evaluate the effectiveness of octreotide for the prevention of postoperative complications after pancreatic surgery through this systematic review and meta-analysis.Methods:Literature databases (including the MEDLINE, EMBASE, and Cochrane databases) were searched systematically for relevant articles. Only randomized controlled trials (RCTs) were eligible for inclusion in our research. We extracted the basic information regarding the patients, intervention procedures, and all complications after pancreatic surgery and then performed the meta-analysis.Results:Thirteen RCTs involving 2006 patients were identified. There were no differences between the octreotide group and the placebo group with regard to pancreatic fistulas (PFs) (relative risk [RR]=0.79, 95% confidence interval [CI]=0.62-0.99, P=.05), clinically significant PFs (RR=1.01, 95% CI=0.68-1.50, P=.95), mortality (RR=1.21, 95% CI=0.78-1.88, P=.40), biliary leakage (RR 0.84, 95% CI=0.39-1.82, P=.66), delayed gastric emptying (RR=0.83, 95% CI=0.54-1.27, P=.39), abdominal infection (RR=1.00, 95% CI=0.66-1.52, P=1.00), bleeding (RR=1.16, 95% CI=0.78-1.72, P=.46), pulmonary complications (RR=0.73, 95% CI=0.45-1.18, P=.20), overall complications (RR=0.80, 95% CI=0.64-1.01, P=.06), and reoperation rates (RR=1.18, 95% CI=0.77-1.81, P=.45). In the high-risk group, octreotide was no more effective at reducing PF formation than placebo (RR=0.81, 95% CI=0.67-1.00, P=.05). In addition, octreotide had no influence on the incidence of PF (RR=0.38, 95% CI=0.14-1.05, P=.06) after distal pancreatic resection and local pancreatic resection.Conclusion:The present best evidence suggests that prophylactic use of octreotide has no effect on reducing complications after pancreatic resection.