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Effects of octreotide on acute pancreatitis of varying severity in rats
U Küçüktülü1, E Alhan, C Erçin
1Department of General Surgery, Karadeniz Technical University School of Medicine, Trabzon, Turkey.
Objective:
To find out the effects of the octreotide on the course of acute pancreatitis in rats.
Design:
Prospective laboratory study.
Setting:
Medical school, Turkey
Animals:
184 Sprague-Dawley rats, 120 of which were randomly allocated into 8 groups of 15 each for the survival study, and the remainder of which were randomly allocated into 8 groups of 8 rats each for assessment of biochemical variables and histological score.
Interventions:
The same 8 groups were used for the two parts of the study: saline alone (control), octreotide alone (control), oedematous pancreatitis induced by cerulein with and without octreotide, moderate pancreatitis induced by low-dose glycodeoxycholic acid and cerulein with and without octreotide, and severe pancreatitis induced by high-dose glycodeoxycholic acid and cerulein with and without octreotide.
Main Outcome Measures:
Mortality, results of biochemical tests, and histological score.
Results:
No rats in the control groups died. Of those with oedematous pancreatitis 1 died that had not been given octreotide (7%) and 2 that had (13%). In the moderate pancreatitis groups 4 that had not been given octreotide died (27%) compared with one that had (7%). In the severe pancreatitis group 7 that had not had octreotide died (46%) compared with 6 that had (40%). Octreotide caused a reduction in serum amylase and lactate dehydrogenase activity in all groups, but reduced aspartate aminotransferase only in those rats with moderate pancreatitis. It prevented hypocalcaemia in rats with severe pancreatitis, but had no effect on serum electrolyte concentrations, alkaline phosphatase activity, or blood gas analyses. Rats with moderate pancreatitis that had been given octreotide had less tissue oedema, acinar necrosis, and inflammatory cell infiltration. In those with severe pancreatitis there was less tissue oedema but more acinar necrosis.
Conclusion:
If octreotide is given early in the course of the disease it may result in improved outcome, but it seems to be ineffective in severe pancreatitis in which acinar necrosis is already established.