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Query: UMLS:C0030305 (pancreatitis)
 16,014 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Multiple therapeutic modalities studied for acute pancreatitis often show a poor correlation between results obtained in experimental studies and results of clinical trials. One of the main reasons for this discrepancy is that in most experimental studies the drugs were administered immediately after induction of pancreatitis, whereas in the clinical setting there is almost always a delay between the onset of the disease and initiation of the treatment. We studied the effects of a delayed treatment with octreotide, the synthetic analogue of the hormone somatostatin, on acute experimental pancreatitis in rats. The disease was induced by intraparenchymal injections of 0.5 ml 5% sodium taurocholate, and octreotide (10 mg/kg/day s.c.) was started either 4 or 12 hr later. Subcutaneous saline injections were used in controls. One-half of the animals of each study group was sacrificed after 36 hr, and the following parameters were examined: pancreatic weight, plasma pH, serum calcium and amylase, and histopathological damage. The same parameters, as well as survival, were assessed after 20 days in the remaining rats. Neither intrapancreatic saline injections, nor octreotide administration without the induction of pancreatitis, caused any biochemical or histological alterations. Hypocalcemia and acidosis in pancreatitis-induced rats were improved by octreotide, but, as expected, it had no effect on amylase levels. Octreotide ameliorated pancreatic edema, intestinal dilatation, and the histopathological injury score 36 hr after induction of pancreatitis. Mortality was 40% in control animals, and only 20% in rats treated with octreotide. Overall, octreotide had beneficial effects in acute experimental pancreatitis, and was more effective when started earlier. These results indicate that octreotide may have a role in the management of acute pancreatitis.
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PMID:Effects of delayed administration of octreotide in acute experimental pancreatitis. 860 96

Somatostatin and its analogue octreotide have a profound inhibitory effect on the endocrine and exocrine secretions of the pancreas, stomach, and small intestine. Previous studies have been inconclusive about the possible therapeutic effect of somatostatin and its analogues in the treatment of pancreatitis. This study assessed the effect of the long acting somatostatin analogue, octreotide, in two models of experimental pancreatitis in rats. Necrotizing pancreatitis was induced by pancreatic injection of 5 ml taurocholate, 5% in male Wistar rats. In a second model mild edematous pancreatitis was induced by intravenous injection of caerulein at a supramaximal dose, 6 micrograms/kg/hr, for 5 hr. Compared to untreated rats, treatment with octreotide either prior to or following the induction of necrotizing pancreatitis resulted in less hypocalcemia (P < 0.05) and acidosis (P < 0.05), and prevented the increase in pancreatic weight (P < 0.05). Amylase levels remained high. After 20 days, there was less pancreatic damage, lower mortality rates (P < 0.05), and increase in body weight (P < 0.05). In the model of milder pancreatitis, octreotide treatment attenuated the increase in pancreatic weight (P < 0.05) and pathological damage (P < 0.05). We concluded that the somatostatin analogue octreotide has a beneficial effect in the treatment of experimental acute pancreatitis.
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PMID:Effect of the somatostatin analogue octreotide on experimental pancreatitis in rats. 863 40

The pancreas commonly reacts to endoscopic papillosphincterotomy (EST) with a rise in serum amylase, and acute pancreatitis may also develop. The long-acting somatostatin analogue octreotide has recently been proposed for prevention of colangiopancreatography (ERCP)/EST-induced pancreatic reaction. Therefore, we tested the prophylactic effects of a subcutaneous 3-day administration of octreotide to 60 consecutive patients undergoing ERCP and EST. They were randomly allocated to receive either 200 micrograms octreotide t.i.d. for 3 days (30 cases) or placebo (control group, 30 cases) before the procedure. On the day of the examination, serum amylase levels were determined at baseline and 2, 4, 8, and 24 h thereafter. In the patients as a whole, the increases were statistically significant at 4 h (p < 0.01) and 8 h (p < 0.01). Epigastric pain occurred in 2 patients in the octreotide group and in 13 control subjects (p < 0.001). Even in some patients who had had previous episodes of relapsing pancreatitis, the rise in serum amylase was significantly lower in the octreotide group than in the control group at 4 h (p < 0.01), 8 h (p = 0.05), and 24 h (p = 0.05). Our data suggest that 3 days of prophylactic treatment with octreotide is effective for reducing the rise in serum amylase after EST/ERCP and could be proposed for patients with relapsing pancreatitis and other risk conditions before the Vater's papilla manipulation.
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PMID:Long-term prophylactic administration of octreotide reduces the rise in serum amylase after endoscopic procedures on Vater's papilla. 878 35

Paediatric oncology continues to search for improved methods for the early detection and effective treatment of solid tumours, especially those of the nervous system, which constitute 50% of all solid tumours in children and adolescents. These tumours, including neuroblastoma, meningioma, low-grade astrocytoma and medulloblastoma express somatostatin receptors and can be imaged effectively using 111In-octreotide. In addition to improved imaging techniques, somatostatin analogues are being developed for use in radioreceptor-guided surgery, as a component of adjuvant chemotherapy and for supportive treatment. Radioreceptor-guided surgery utilises 125I-Tyr3-octreotide or 125I-lanreotide to detect tumour foci within minutes of injection. It allows the detection of 0.1-1.0 mg tumour (1 x 10(5) to 1 x 10(6) tumour cells). This technique has successfully located foci of occult tumour in children with neuroblastoma. Somatostatin analogues are also currently being studied as tumour growth inhibitors between regular chemotherapy cycles and for the treatment of chemotherapy-induced pancreatitis in children with leukaemia. Research on somatostatin receptor subtype expression in paediatric tumours suggests that further investigation of analogue effects on growth inhibition and induction of differentiation will contribute to improved therapy for children with solid tumours.
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PMID:Clinical use of somatostatin analogues in paediatric oncology. 881 66

Major pancreatic resection is still accompanied by considerable morbidity (35%) and mortality (10%). Typical complications, such as pancreatic fistula and abscess, are chiefly associated with exocrine pancreatic secretion. The hormone somatostatin and its analogue octreotide are well known as potent inhibitors of exocrine pancreatic secretion. In two randomised, double-blind, placebo-controlled, multicentre trials we assessed the prophylactic effect of the perioperative inhibition of exocrine pancreatic secretion by octreotide to prevent postoperative complications. Each patient received 3 X 100 micrograms/day octreotide or placebo subcutaneously. A significant reduction in fistula, abscess, fluid collection, sepsis and postoperative pancreatitis occurred with patients undergoing pancreatic resection for cancer. Results were similar in a second study, using the same protocol but recruiting only patients with chronic pancreatitis. A new randomised, controlled multicentre trial is also described, in which 300 patients with severe acute pancreatitis are being treated with or without octreotide in double-blind fashion. The results will clarify the influence of inhibition of exocrine pancreatic secretion by octreotide on the course of acute pancreatitis, and hence its potential, through inhibition of digestive enzyme secretion, as a treatment for acute pancreatitis.
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PMID:Efficacy of somatostatin and its analogues in pancreatic surgery and pancreatic disorders. 881 84

Sixteen primary pancreatic tumors were found in a retrospective study of bovine pancreatic lesions detected in slaughtered cattle. Eleven islet cell tumors and three pancreatic exocrine carcinomas were identified based on light microscopy and immunohistochemistry. Nine of 11 islet cell tumors were classified as malignant. Metastatic sites included iliac, mediastinal, hepatic, and mesenteric lymph nodes, peritoneum, mesentery, and liver. Six cows with multiple islet cell tumors also had pheochromocytomas. All 11 islet cell tumors had positive immunoreactivity to insulin and somatostatin. Three tumors also contained cells immunoreactive for glucagon and two tumors contained pancreatic polypeptide immunoreactive cells. Immunoreactivity of tumor cells in metastatic sites was similar to their respective primary tumors. All exocrine pancreatic carcinomas metastasized widely and were immunonegative for insulin, somatostatin, glucagon, and pancreatic polypeptide. No mixed endocrine-exocrine tumors were identified. None of the endocrine or exocrine tumors contained amyloid. Additional primary tumors of the bovine pancreas included one neurofibroma and one neurofibrosarcoma. Additional cases with lesions of the bovine pancreas included nodular hyperplasia in 15 cows, exocrine acinar atrophy and fibrosis in four cows (two of which also had pancreatic lithiasis), pancreatitis in one cow, peripancreatic fibrosis in two cows, pancreatic steatosis in one animal, and pancreatic hemorrhages in one cow.
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PMID:A retrospective study of pancreatic tumors in slaughter cattle. 881 37

We report a well-documented case of relapsing chronic calcifying pancreatitis with recurrent pleural and pericardial effusions during episodes of clinical and biochemical relapse of the pancreatitis. Pericardial effusions in association with pancreatitis have been reported only very occasionally, almost exclusively in chronic alcoholic pancreatitis with pseudocyst formation. Our successful conservative treatment consisted of parenteral nutrition and a continuous infusion of somatostatin for 6 weeks. We discuss other reported cases and proposed mechanisms of pathogenesis.
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PMID:Recurrent pericardial effusion as a result of chronic pancreatitis. Successful treatment with somatostatin. 889 8

We report two patients who had non-surgical management of Pancreatic Pseudocyst. The first patient presented with acute pancreatitis and intestinal obstruction, had laparatomy and found to have hemorrhagic pancreatitis and impacted gallstone in terminal item which was removed. Two weeks after laparatomy U/S and CT showed a dilated CBD and two Pancreatic Pseudocysts. ERCP showed dilated CBD. Endoscopic sphincterotomy and stent insertion in CBD and Cystoduodenostomy was done. A percutaneous drainage was done for the pseudocyst involving the body of the pancreas. The second patient presented abdominal pain and clinically had an abdominal mass which was shown by CT as Pseudopancreatic cyst. This was drained percutaneously and given treatment with somatostatin with good outcome.
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PMID:Non surgical management of pancreatic pseudocyst: two case reports and review of the literature. 890 70

Pancreatic pseudocyst is a know complication of acute pancreatitis and pancreatic trauma. The treatment of pancreatitis remains a challenge and the pancreatic pseudocyst is often approached surgically. Lately, the use of somatostatin and its long-acting analogue octreotide have proved useful in the treatment of pancreatitis and its complications in adults. This is the first report on the use of somatostatin in the treatment of a pancreatic pseudocyst in a child. We present the case of a posttraumatic pancreatic pseudocyst in a 10-year-old boy, regressing rapidly under somatostatin treatment, by which means surgical re-intervention could be avoided.
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PMID:Somatostatin in the treatment of a pancreatic pseudocyst in a child. 895 80

Sphincter of Oddi dysfunction has been reported as a cause of acute idiopathic recurrent pancreatitis (IRP). Octreotide, a long-acting somatostatin analogue, is an antisecretory drug used in the treatment and prevention of acute pancreatitis. Its action on sphincter of Oddi motility is controversial and no data are available for IRP patients. The aim of this study was to assess sphincter of Oddi motor response to acute administration of octreotide in patients with past attacks of acute pancreatitis without identification of any evident aetiological factor. Six patients (four male, two female; mean age +/-SD, 38.8+/-9 years) suffering from acute pancreatitis for at least 3 months before the examination were submitted to sphincter of Oddi manometry. After a basal recording lasting at least 2 min, octreotide, 0.05 mg i.v., was administered and the recording repeated. Intraduodenal pressure was taken as the zero reference and the basal sphincter of Oddi pressure and amplitude and frequency of phasic contractions were calculated before and after octreotide administration. No significant pre- vs post-octreotide differences were observed in basal pressure (41.9+/-24 vs 47.5+/-33 mm Hg, respectively) or in amplitude of phasic contractions (164.6+/-33 vs 170.8+/-18 mm Hg). With a latency of about 1 min, octreotide administration caused a high-frequency phasic activity in all cases (mean frequency, 5.5+/-2.2 contractions/min before and 9.8+/-2 after octreotide; P < 0.04). After the procedure acute pancreatitis (prolonged abdominal pain and serum amylase levels more than three-fold the normal values) developed in five patients. In conclusion, our data suggest that acute administration of octreotide may induce tachyoddia and thus a rise in sphincter of Oddi pressure, with possible impairment of biliary-pancreatic outflow.
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PMID:Effect of octreotide on sphincter of Oddi motility in patients with acute recurrent pancreatitis: a manometric study. 901 48


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