[Gastrointestinal fistulas. Treatment with a somatostatin analogue (SMS 201-995)]

Post surgical gastrointestinal fistulas are a frequent problem around the world. We present our experience with a synthetic analog of somatostatin (SMS 201-955) used in 19 patients with gastrointestinal fistulas between January 1992 [corrected] and November 1993. We compare them with 50 patients with gastrointestinal fistulas randomized selected between 1980. The fistulas were classified according to their topographic location in five groups and to their flow in two groups: high and low fistulas. All patients were treated with nutritional support, antibiotic and octreotide (SMS 201-995). In the first 24 hours the fistulas flow where reduced in 51.63% and 72 hours later the reduction was of 70.62%. In 13 patients the fistulas where closed between 36.7 + 0 - 13.94 days (p < 0.01). This difference represent a cost reduction of 1,220,673.96 Bs. for each patient or 45,581.55 Bs. for each day. Two patients died in the study (10.52%) and two patients stop the drug because of adverse reaction. The octreotide reduced the fistulas flow and reduced the time needed to close.