각종 췌장질환에서 Somatostatin Analogue 사용 경험

Background/Aims: Octreotide, long-acting analogue of somatostatin, has been used for symptomatic carcinoid syndrome and vasoactive intestinal peptide-producing tumors. In pancreatic diseases, however, the effect of octreotide has not been settled yet. The aim of this study was to evaluate the effect of octreotide in various pancreatic diseases which did not respond to conventional medical treatment. Methods: We reviewed retrospectively the medical records of 28 patients who were admitted at the Asan Medical Center from January 1997 to June 1999. Their diseases were pancreatic fistula (n=9), pancreatic pseudocysts (n=17), and pancreatic ascites (n=2). Octreotide was administered subcutaneously at a dose of 0.1 mg every 12 hours. Results: In the cases of pancreatic fistulas, the mean output of baseline fistula was 289 cc/day. This was decreased to 178 cc/day on the first day of octreotide therapy and to 49 cc/day on the seventh day. Five (56%) patients eventually closed their fistulas. In the cases of pancreatic pseudocysts, 11 (65%) cases had showed complete resolution of pseudocysts. The remaining 6 cases which showed no improvement were treated operatively. In the cases of pancreatic ascites, the two patients (100%) were successfully treated with octreotide. Conclusions: Octreotide seems to be a safe and useful alternative therapy in patients with pancreatic fistulas, pseudocysts or ascites who do not respond to conventional medical management. Further detailed study may be necessary for the establishment of the role of octreotide in the treatment of various pancreatic diseases. (Kor J Gastroenterol 2000;35:784 - 789)