Systematic review and meta-analysis of somatostatin analogues for the treatment of pancreatic fistula

Background: Somatostatin analogues are used for the treatment of pancreatic fistula, with the aim of achieving fistula closure or reduction of output. Method: MEDLINE, Embase and Cochrane databases were searched systematically for relevant articles followed by hand‐searching of reference lists. Data on patient recruitment, intervention and outcome were extracted and meta‐analysis performed where reasonable. Results: Seven randomized clinical trials met the inclusion criteria and included a total of 297 patients with fistulas of the gastrointestinal tract; of these, 102 patients had fistulas of pancreatic origin. Pooling of closure rates showed no significant difference between patients treated with somatostatin analogues compared with controls: odds ratio 1·52 (95 per cent confidence interval 0·88 to 2·61). Owing to inconsistent descriptions, pooling of results was not possible for other endpoints, such as time to fistula closure. Conclusion: There is no solid evidence that somatostatin analogues result in a higher closure rate of pancreatic fistula compared with other treatments. Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. No evidence that it works