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  • Title: Systematic review and meta-analysis of the role of somatostatin and its analogues in the treatment of enterocutaneous fistula.
    Author: Stevens P, Foulkes RE, Hartford-Beynon JS, Delicata RJ.
    Journal: Eur J Gastroenterol Hepatol; 2011 Oct; 23(10):912-22. PubMed ID: 21814141.
    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.
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